Anthrax pneumonia

Inhalation anthrax is a rare and almost uniformly fatal form of human anthrax caused by the inhalation of spores of Bacillus anthracis. A clue to the diagnosis is provided by taking a work history which will disclose patient exposure to contaminated animal products, most often animal hair and wool used in the textile industry. It is an illness with a biphasic course marked by the presence of a widened mediastinum on chest radiograph and often accompanied by hemorrhagic meningitis. The pathogenesis of this disease as well as the differential diagnosis of inhalation anthrax in the context of other zoonotic pneumonias is discussed. Therapy has been ineffectual probably because it has begun too late, but includes intravenous high dose penicillin G and perhaps vaccination to prevent relapse.