Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 17;75(Suppl 3):S459-S467.
doi: 10.1093/cid/ciac533.

Risk Factors for Death or Meningitis in Adults Hospitalized for Cutaneous Anthrax, 1950-2018: A Systematic Review

Julie M Thompson  1 , Rachel Cook  2 , Marissa K Person  3 , María E Negrón  3 , Rita M Traxler  3 , William A Bower  3 , Katherine Hendricks  3
Affiliations

Risk Factors for Death or Meningitis in Adults Hospitalized for Cutaneous Anthrax, 1950-2018: A Systematic Review

Julie M Thompson et al. Clin Infect Dis. .

Abstract

Background: Cutaneous anthrax accounts for approximately 95% of anthrax cases worldwide. About 24% of untreated patients die, and many cases are complicated by meningitis. Here, we explore clinical features of cutaneous disease associated with poor outcomes.

Methods: A systematic review identified 303 full-text articles published from 1950 through 2018 that met predefined inclusion criteria. Cases were abstracted, and descriptive analyses and univariate logistic regression were conducted to identify prognostic indicators for cutaneous anthrax.

Results: Of 182 included patients, 47 (25.8%) died. Previously reported independent predictors for death or meningitis that we confirmed included fever or chills; nausea or vomiting; headache; severe headache; nonheadache, nonmeningeal signs; leukocytosis; and bacteremia. Newly identified predictors included anxiety, abdominal pain, diastolic hypotension, skin trauma, thoracic edema, malignant pustule edema, lymphadenopathy, and evidence of coagulopathy (all with P < .05).

Conclusions: We identified patient presentations not previously associated with poor outcomes.

Keywords: anthrax; cutaneous; mass casualty incident; triage; with cutaneous anthrax.

PubMed Disclaimer

References

    1. Carlson CJ, Kracalik IT, Ross N, et al. The global distribution of Bacillus anthracis and associated anthrax risk to humans, livestock and wildlife. Nat Microbiol 2019; 4:1337–43. - PubMed
    1. Anthrax DM. In: Cohen J, Powderly WG, Opal SM, eds. Infectious diseases. 4th ed. Elsevier, 2017:1123–8.e1.
    1. World Health Organization, ed. Anthrax in humans and animals. 4th ed. Geneva, Switzerland: World Health Organization, 2008.
    1. Doganay M, Metan G, Alp E. A review of cutaneous anthrax and its outcome. J Infect Public Health 2010; 3:98–105. - PubMed
    1. Navdarashvili A, Doker TJ, Geleishvili M, et al. Human anthrax outbreak associated with livestock exposure: Georgia, 2012. Epidemiol Infect 2016; 144:76–87. - PMC - PubMed

Publication types

Supplementary concepts

Grants and funding