GASTROINTESTINAL ANTHRAX: REVIEW OF NINE PATIENTS

Background – Gastrointestinal anthrax is quite rare and often fatal. Here we report the clinical presentation and outcome of nine patients with this disease. Methods – The medical records of all patients with documented anthrax admitted to our university hospitals from 1975 to 2000 were reviewed. Nine patients were found to have gastrointestinal anthrax. Data regarding the clinical presentation, incubation period, site of involvement, history of animal contact and/or ingestion of contaminated meat, complications, and clinical outcome of the cases with gastrointestinal anthrax were looked for and recorded. Results – There were 7 males and 2 females with an age range of 3 to 70 years. The most important features included upper gastrointestinal bleeding, ascites, disseminated intravascular coagulation, and early mortality in 8 (88%) patients. The incubation period ranged from 2 to 7 days. Eight patients had history of contact with animals or infected animal products, 4 of whom had ingested raw, uncooked meat of dead sheep as well. One patient presented with acute abdomen mandating laparotomy. Only one patient survived and was discharged after 52 days of intensive care management. Conclusion – Gastrointestinal anthrax, although rare, continues to be a dreadful consequence of consumption of raw or undercooked meat of infected animals. Public education and proper animal vaccination, especially in areas where anthrax is prevalent may prevent a large number of such cases.