Gastrointestinal anthrax is rare but it is a life-threatening infection.
Routes of infection:
(1) inhalation of an aerosol of spores
(2) ingestion of food containing anthrax spores, especially if inadequately cooked
Sites of infection: from oropharynx to cecum
Features may include:
(1) fever and malaise
(2) abdominal pain
(3) nausea and vomiting
(4) sepsis with toxemia
(5) inflammatory lesions at site of exposure with ulceration
(6) regional lymphadenopathy
(7) variable ascites
(8) variable perforation
(9) variable hemorrhage, which can be massive
(10) variable bowel obstruction
Phases of evolution:
(I) low-grade fever, syncope, malaise
(II) abdominal pain, nausea, vomiting, abdominal distention
(III) ascites, toxemia, shock, paroxysmal abdominal pain
Fatal cases can evolve quickly, over 2-3 days.
Risk factors for poor outcome:
(1) delay in diagnosis
(2) fulminant course
(3) failure to treat adequately
(4) massive gastrointestinal hemorrhage or perforation
