Anthrax is a rare, life-threatening infection. It leads to swelling, bleeding, and tissue death.
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Certain bacteria and its spores cause anthrax. They are found in soil and animals. The spores can get into the body in several ways:
- Cutaneous—from breaks in the skin
- Inhalation—by breathing them in
- Gastrointestinal—by eating raw or undercooked meat that has spores
Once in the body, the spores multiply and release toxins.
The risk of anthrax is higher in those who:
- Live in or travel to places where it is common, such as:
- sub-Saharan Africa
- the Caribbean
- Southern and Eastern Europe
- South and Central America
- Work with animals and animal hides
- Work with the bacteria in labs
- Are exposed to criminal or terrorist acts
Symptoms start within a few days after infection.
Cutaneous symptoms may be:
- A raised, round, itchy bump, like an insect bite
- Skin ulcers with a black center—they make a clear or pinkish fluid
- Swelling around the wound
- Swollen, painful lymph nodes
Inhalation symptoms start with:
- Tiredness or weakness
- Soreness and swelling in the throat
- Swollen lymph nodes
- Fever and chills
- Headache and muscle aches
Other symptoms begin later such as:
- Severe breathing problems
- Chest pain
Gastrointestinal symptoms can be:
- In the mouth or throat, with:
- Swelling in the neck
- Whitish ulcers
- In the intestines, with:
- Nausea and vomiting
- Belly pain
- Bloody diarrhea
The doctor will ask about your symptoms and health history. A physical exam may be done. The doctor may give tests to rule out other causes.
Tests to diagnose anthrax may be:
- Blood tests
- Tests of fluids, stool, wounds, or tissues
- Imaging tests such as chest x-rays
Treatment will start right away. It will involve:
- Antibiotics—to treat the infection
- Antibodies—to target bacteria (inhalation anthrax)
- Cleaning and bandaging skin lesions
- Supportive care—to maintain heart function, blood pressure, and oxygen
The risk of anthrax may be reduced by:
- Avoiding contact with infected animals and their products
- Not touching anthrax wounds
- Handling suspicious mail carefully
A vaccine may be given to some people at high risk for anthrax.
Centers for Disease Control and Prevention
Military Health System
Public Health Agency of Canada
Anthrax. Centers for Disease Control and Prevention website. Available at: https://www.cdc.gov/anthrax. Accessed February 2, 2021.
Anthrax. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/anthrax Accessed February 2, 2021.
Anthrax. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/anthrax. Accessed February 2, 2021.
Bower WA, Schiffer J, et al. Use of anthrax vaccine in the United States: recommendations of the advisory committee on immunization practices, 2019. MMWR Recomm Rep. 2019;68(4):1-14.
Last reviewed September 2020 by David L. Horn, MD, FACP Last Updated: 2/2/2021