Inhalation Anthrax
Where anthrax spores inhaled and enter the respiratory tract. Inhaled anthrax spores began with the entry into the alveolar cavity, then will phagocytosing macrophages and most of the spores spores will be analyzed and broken. Spores are still alive will spread to the lymph nodes and mediastinal nodes. The process of changing vegetative form occurs approximately 60 days later. The slow process of change in shape is not known with certainty, but well documented in Sverdlovsk, that cases of inhalation anthrax occurred between day 2 to day 43 after exposure.
Once germination has occurred, the disease will arise quickly and replication of bacteria causing hemorrhage, edema, and necrosis. In the classical clinical symptoms of inhalation anthrax are biphasic. In the initial phase, the incubation period of 1-6 days after onset of symptoms that are not typical of a low-grade fever, malaise, non-productive cough, chest or abdominal pain, and usually without any physical abnormalities, the disease will go into the second phase. In this phase sudden fever, acute shortness of breath, diaphoresis, and cyanosis. Caused by enlarged lymph nodes, mediastinal widening, and subcutaneous edema in the chest and neck which can lead to obstruction of the tracheal stridor may occur.
Cutaneous Anthrax (skin anthrax)
Where anthrax spores enter through broken skin. The process of spore entry into humans, mostly cutaneous anthrax (95% of cases). Almost 95% of cases occurring anthrax is cutaneous anthrax in the United States. Patients usually have a history of contact with animals or their products. Some reported cases of cutaneous anthrax contracted from insect bites that allegedly infected from eating carcasses containing anthrax. Affected areas, especially the face, extremities, or neck. Endospores enter through skin abrasions or wounds. One to seven days after entry endospores, which formed the primary skin lesions are not painful and itchy papules.
Twenty-four to 36 hours later lesions forming vesicles containing clear fluid or serosanguineus, and contains many Gram-positive bacteria. Vesicle then undergoes central necrosis, drying and cause eskar (necrotic ulcers) blackish typical vesicles surrounded by edema and purplish. Edema usually occurs more intense on the head or neck than the body or limbs. Lymphangitis and painful lymphadenopathy can be found following systemic symptoms occur. Although cutaneous anthrax can heal itself, but still need to be given antibiotics (to reduce systemic symptoms). At 80-90% of cases the lesions healed completely with no complications or scarring.
Rare malignant edema, characterized by severe edema, induration, multiple bullae, and shock. Malignant edema can occur in the neck and chest area which causes difficulty breathing, requiring corticosteroids or intubation.
Gastrointestinal Anthrax
Where's the meat of animals that consumed not cooked properly so that they lack the spore and consumed. Symptoms usually occur 2-5 days after eating raw or undercooked meat contaminated with germs. Some cases may occur in the home. At pathology examination under a microscope can be found in the mucosa and submucosa basil lymphoid tissue and mesenteric lymphadenitis. Ulceration is almost always found. In the tissues around the site of infection found massive edema and necrosis. A large number of Gram-positive bacteria can be found in the peritoneal fluid.
Mediastinal widening can also occur. Clinical symptoms include fever, diffuse abdominal pain, constipation, or diarrhea. Therefore ulceration that occurs then defecate or vomit into a blackish or reddish. Can occur purulent ascites clear up (if done frequently found colonies cultured B. anthracis). Deaths caused by bleeding, fluid and electrolyte balance disorders, perforation, shock, or toxemia. If the patient can survive the most of the symptoms will disappear within 10-14 days. Deposition and germination of spores in the oropharynx can cause oropharyngeal anthrax. Clinical symptoms of illness teggorokan great, fever, dysphagia, and sometimes because of massive edema lymphadenitis and respiratory distress may occur.
