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09 September 2002

GI Anthrax: report of one case confirmed with autopsy

Faribourz Mansour-Ghanaei, Shahab Zareh, Arezoo Salimi

Med Sci Monit 2002; 8(9): CS73-76 :: ID: 13492

Abstract

Background: Bacillus Anthraces is a non-motile, rod like, gram-positive and aerobic bacillus that produces central oval-shaped spores and characterized by rough, irregular and often comma-shaped colonies in blood agar. About 95% of human anthrax is cutaneous and 5% respiratory. GI anthrax, a very rare type, has been reported in less than 1% of all cases. We thus report a case of GI anthrax
with autopsy findings.
Case report: A 15-year-old young adult man was admitted to our hospital with history of fever, abdominal pain and bloody diarrhea from 48 hours after ingestion of half-cooked sheep’s meat. In endoscopic exam of upper GI tract, the esophagus had been filled with fresh blood without any varices, stomach showed evidence of hemorrhage and had multiple erosion but no ulceration of
duodenum. Penicillin G 24,000,000 U/day IV was started but unfortunately severe upper and lower GI hemorrhage developed, leading to hypotension and death. In autopsy, ascites, paraaortic and mesenteric lymphadenopathy was accident with some of them being hemorrhagic. The spleen was slightly enlarged with hemorrhagic congestion in some parts of it. In the blood sample drawn from the spleen, the filamentous bacillus was successfully found.
Conclusions: Because of the fatal nature of the disease and the similarity of the signs and symptoms to the other gastrointestinal diseases, we should consider it as one of the probable differential diagnosis in the patients with upper and lower gastrointestinal bleeding with fever esp. in the endemic areas.

Keywords: Intestine, Small - pathology

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