|
1
|
Pertea M, Luca S, Moraru DC, Veliceasa B, Filip A, Grosu OM, Poroch V, Panuta A, Luca CM, Avadanei AN, Lunca S. Upper Limb Compartment Syndrome-An Extremely Rare Life-Threatening Complication of Cutaneous Anthrax. Microorganisms 2024; 12:1240. [PMID: 38930622 PMCID: PMC11205670 DOI: 10.3390/microorganisms12061240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 06/16/2024] [Accepted: 06/18/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: Cutaneous anthrax is a disease caused by a Gram-positive bacillus, spore-forming Bacillus anthracis (BA). Cutaneous anthrax accounts for 95% of all anthrax cases, with mortality between 10-40% in untreated forms. The most feared complication, which can be life-threatening and is rarely encountered and described in the literature, is compartment syndrome. (2) Methods: We report a series of six cases of cutaneous anthrax from the same endemic area. In two of the cases, the disease was complicated by compartment syndrome. The systematic review was conducted according to systematic review guidelines, and the PubMed, Google Scholar, and Web of Science databases were searched for publications from 1 January 2008 to 31 December 2023. The keywords used were: "cutaneous anthrax" and "compartment syndrome by cutaneous anthrax". (3) Results: For compartment syndrome, emergency surgical intervention for decompression was required, along with another three surgeries, with hospitalization between 21 and 23 days. In the systematic review, among the 37 articles, 29 did not contain cases focusing on compartment syndrome of the thoracic limb in cutaneous anthrax. The results were included in a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flow diagram. (4) Conclusions: Early recognition of the characteristic cutaneous lesions and compartment syndrome with early initiation of antibiotics and urgent surgical treatment is the lifesaving solution.
Collapse
Affiliation(s)
- Mihaela Pertea
- Department Plastic Surgery and Reconstructive, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.P.); (S.L.); (D.C.M.); (O.M.G.)
- Department of Plastic Surgery and Reconstructive Microsurgery, “Sf. Spiridon” Emergency County Hospital, 700111 Iasi, Romania;
| | - Stefana Luca
- Department Plastic Surgery and Reconstructive, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.P.); (S.L.); (D.C.M.); (O.M.G.)
- Department of Plastic Surgery and Reconstructive Microsurgery, “Sf. Spiridon” Emergency County Hospital, 700111 Iasi, Romania;
| | - Dan Cristian Moraru
- Department Plastic Surgery and Reconstructive, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.P.); (S.L.); (D.C.M.); (O.M.G.)
- Department of Plastic Surgery and Reconstructive Microsurgery, “Sf. Spiridon” Emergency County Hospital, 700111 Iasi, Romania;
| | - Bogdan Veliceasa
- Department of Orthopaedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Department of Orthopaedics and Traumatology, “Sf. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Alexandru Filip
- Department of Orthopaedics and Traumatology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Department of Orthopaedics and Traumatology, “Sf. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Oxana Madalina Grosu
- Department Plastic Surgery and Reconstructive, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (M.P.); (S.L.); (D.C.M.); (O.M.G.)
| | - Vladimir Poroch
- Department of Palliative Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Palliative Oncological Clinic, Regional Institute of Oncology, 700483 Iasi, Romania
| | - Andrian Panuta
- Department of Plastic Surgery and Reconstructive Microsurgery, “Sf. Spiridon” Emergency County Hospital, 700111 Iasi, Romania;
- Department of Surgery I, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
| | - Catalina Mihaela Luca
- Department of Infectious Diseases, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania;
- Clinic of Infectious Diseases, “Sf. Parascheva” Clinical Hospital of Infectious Diseases, 700116 Iasi, Romania
| | - Andrei Nicolae Avadanei
- Department of Vascular Surgery, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Department of Vascular Surgery, “Sf. Spiridon” Emergency County Hospital, 700111 Iasi, Romania
| | - Sorinel Lunca
- Department of Surgery I, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Second Oncological Clinic, Regional Institute of Oncology, 700483 Iasi, Romania
| |
Collapse
|
|
2
|
Black H, Chapman A, Inverarity D, Sinha S. Heroin-associated anthrax with minimal morbidity. BMJ Case Rep 2017; 2017:bcr2016218316. [PMID: 28275017 PMCID: PMC5353407 DOI: 10.1136/bcr-2016-218316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 11/04/2022] Open
Abstract
In 2010, during an outbreak of anthrax affecting people who inject drugs, a heroin user aged 37 years presented with soft tissue infection. He subsequently was found to have anthrax. We describe his management and the difficulty in distinguishing anthrax from non-anthrax lesions. His full recovery, despite an overall mortality of 30% for injectional anthrax, demonstrates that some heroin-related anthrax cases can be managed predominately with oral antibiotics and minimal surgical intervention.
Collapse
Affiliation(s)
- Heather Black
- Department of Infectious Diseases, Monklands Hospital, Airdrie, UK
| | - Ann Chapman
- Department of Infectious Diseases, Monklands Hospital, Airdrie, UK
| | | | - Satyajit Sinha
- Department of Orthopaedics, Monklands Hospital, Airdrie, UK
| |
Collapse
|
|
3
|
Cote CK, Welkos SL. Anthrax Toxins in Context of Bacillus anthracis Spores and Spore Germination. Toxins (Basel) 2015; 7:3167-78. [PMID: 26287244 PMCID: PMC4549744 DOI: 10.3390/toxins7083167] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 08/08/2015] [Accepted: 08/11/2015] [Indexed: 11/18/2022] Open
Abstract
The interaction of anthrax toxin or toxin components with B. anthracis spores has been demonstrated. Germinating spores can produce significant amounts of toxin components very soon after the initiation of germination. In this review, we will summarize the work performed that has led to our understanding of toxin and spore interactions and discuss the complexities associated with these interactions.
Collapse
Affiliation(s)
- Christopher K Cote
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Bacteriology Division, 1425 Porter Street, Fort Detrick, Frederick, MD 21702-5011, USA.
| | - Susan L Welkos
- United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Bacteriology Division, 1425 Porter Street, Fort Detrick, Frederick, MD 21702-5011, USA.
| |
Collapse
|