Cutaneous Anthrax in the Central Anatolia Region of Turkey: A Review of 39 Adults Cases

Objective: Anthrax is a zoonotic infectious disease that caused by Bacillus anthracis. Sporadic anthrax is still present world-wide, particularly in animal raising countries including Turkey. The aim of this study was to evaluate the epidemiological, clinical, and laboratory findings and treatment protocols of adult patients with cutaneous anthrax retrospectively. Material and Methods: A retrospective review of 39 adult patients with cutaneous anthrax presented between 1983 and 2005, in Cumhuriyet University Hospital in Sivas, a city located in the central Anatolia region of Turkey was carried out. Results: Of the 39 cases with the diagnosis of cutaneous anthrax, 27 (69.2%) were males and 12 (30.8%) were females. The mean age was 44 (range, 1674) years. The clinical presentations were severe edema due to anthrax in 10 (26%) and typical pustuler lesion in 29 (74%) patients. The lesions were mostly located on the hand and forearm. Twenty-five cases (64.1%) had a history of recent animal slaughtering activity. Culturing of 39 wound specimens yielded 17 (43.6%) B. anthracis strains. Thirty-six (92.3%) patients were treated with penicillin G. A patient with severe cutaneous anthrax and extensive edema died on the first admission day. Mortality rate was 2.6%. Conclusion: Although the incidence of anthrax is decreasing world-wide, it is still encountered in Turkey. Preventive measures such as education of the risk population and vaccinaton of animals against anthrax would reduce the incidence of the disease. We suppose that penicillin is still the antibiotic of choice for the treatment of cutaneous anthrax in endemic regions.