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Case Reports
. 2020 Jun 30;8(7):985.
doi: 10.3390/microorganisms8070985.

Case Report of an Injectional Anthrax in France, 2012

Jean-Marc Thouret  1 , Olivier Rogeaux  1 , Emmanuel Beaudouin  1 , Marion Levast  1 , Vincent Ramisse  2 , Fabrice V Biot  3   4 , Eric Valade  3   5   6 , François Thibault  3 , Olivier Gorgé  3   4 , Jean-Nicolas Tournier  3   4   6
Affiliations
Case Reports

Case Report of an Injectional Anthrax in France, 2012

Jean-Marc Thouret et al. Microorganisms. .

Abstract

(1) Background: Bacillus anthracis is a spore-forming, Gram-positive bacterium causing anthrax, a zoonosis affecting mainly livestock. When occasionally infecting humans, B. anthracis provokes three different clinical forms: cutaneous, digestive and inhalational anthrax. More recently, an injectional anthrax form has been described in intravenous drug users. (2) Case presentation: We report here the clinical and microbiological features, as well as the strain phylogenetic analysis, of the only injectional anthrax case observed in France so far. A 27-year-old patient presented a massive dermohypodermatitis with an extensive edema of the right arm, and the development of drug-resistant shocks. After three weeks in an intensive care unit, the patient recovered, but the microbiological identification of B. anthracis was achieved after a long delay. (3) Conclusions: Anthrax diagnostic may be difficult clinically and microbiologically. The phylogenetic analysis of the Bacillus anthracis strain PF1 confirmed its relatedness to the injectional anthrax European outbreak group-II.

Keywords: drug-user; injectional anthrax; outbreak; phylogeny.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Microbiological features of the Bacillus anthracis strain. (A) Gram-positive “jointed bamboo-rod” bacilli forming long chains pathognomonic of B. anthracis. (B) Black ink negative staining of the B. anthracis bacilli capsule. The capsule repels the ink around the bacilli chains.
Figure 2
Figure 2
Phylogenetic analysis of B. anthracis strains. (A) Phylogenic tree of single-nucleotide polymorphism (SNP) profiles found among Group II strains. Position is calculated from Ames Ancestor Reference Genome. (B) Minimum spanning tree based on SNP profiles among Group II strains. (A,B) The different strains groups are color-coded by their geographical origin: red, original Norwegian strain; orange, French strain described here; light blue, English strains; yellow, Scottish strain; black, German strains; gray; Danish strains.
See this image and copyright information in PMC

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