Diagnosis

Your doctor will ask you what kind of work you do, along with other questions to determine the likelihood of your having been exposed to anthrax. He or she will first want to rule out other, more-common conditions that may be causing your signs and symptoms, such as flu (influenza) or pneumonia.

Tests

You may have a rapid flu test to quickly diagnose a case of influenza. If other tests are negative, you may have further tests to look specifically for anthrax, such as:

  • Skin testing. A sample of fluid from a suspicious lesion on your skin or a small tissue sample (biopsy) may be tested in a lab for signs of cutaneous anthrax.
  • Blood tests. You may have a small amount of blood drawn that's checked in a lab for anthrax bacteria.
  • Chest X-ray or computerized tomography (CT) scan. Your doctor may request a chest X-ray or CT scan to help diagnose inhalation anthrax.
  • Stool testing. To diagnose gastrointestinal anthrax, your doctor may check a sample of your stool for anthrax bacteria.
  • Spinal tap (lumbar puncture). In this test, your doctor inserts a needle into your spinal canal and withdraws a small amount of fluid. A spinal tap is recommended any time doctors suspect systemic anthrax — anthrax other than cutaneous — due to the possibility of meningitis.

Treatment

The standard treatment for anthrax is an antibiotic such as ciprofloxacin (Cipro), doxycycline (Vibramycin) or levofloxacin. Which single antibiotic or combination of antibiotics, and the length of treatment, will be most effective for you depends on how you were infected with anthrax, your age, your overall health and other factors. Treatment is most effective when started as soon as possible.

Since the 2001 attacks in the United States, researchers have developed antitoxin therapies — raxibacumab and obiltoxaximab — for inhalation anthrax. Instead of going after the bacteria that causes the disease, these medications help eliminate the toxins caused by the infection. Anthrax immunoglobulin also may be used to neutralize the toxins. These medications are given in addition to antibiotics and are available to doctors through the U.S. Centers for Disease Control and Prevention.

Some cases of injection anthrax have been successfully treated with surgical removal of infected tissue.

Although some cases of anthrax respond to antibiotics, advanced inhalation anthrax may not. By the later stages of the disease, the bacteria have often produced more toxins than drugs can eliminate.

Along with antibiotics, people with anthrax may be treated with intensive supportive care including ventilators, fluids and medicines to tighten blood vessels and raise blood pressure (vasopressors).

Preparing for your appointment

Symptoms of anthrax often come on suddenly and can be very serious. If you know you've been exposed to anthrax or if you develop symptoms after a possible exposure, immediately go to the emergency room.

If you have time before you go:

  • Write down any symptoms you're experiencing, including any that seem unrelated to anthrax exposure.
  • Write down key personal information. Have you recently traveled to a part of the world where anthrax is endemic? Are you exposed to livestock, game animals or animal skins in your work or hobbies?
  • Make a list of all medications, vitamins and supplements that you're taking.
  • Take a family member or friend along, if possible. Sometimes it can be difficult to recall the information provided to you in the hospital or during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write down questions to ask your doctor. For instance, if you're diagnosed with anthrax, you will want to know the route of infection, the proposed treatment and your prognosis.
May 15, 2020
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