Forms of the disease
The clinical picture depends on how the bacteria entered the body. The vast majority of cases in humans are the cutaneous form, which occurs when spores come into contact with damaged skin of the hands, face or neck. The intestinal form develops after eating meat from a sick animal. Pulmonary occurs when inhaling dust with spores during processing of wool and skins and is considered the most severe. Separately, there is an injection form associated with the introduction of contaminated substances. The infection is usually not transmitted from person to person.
- Cutaneous form - more than ninety percent of cases in humans
- Intestinal form - after eating contaminated meat
- Pulmonary form - by inhaling spores
- Injection form
- Generalization with sepsis and meningitis in any form
What does the skin form look like?
A few days after contact, a reddish spot appears on the skin, which turns into a nodule, then into a vesicle with cloudy or dark contents. The vesicle opens and an ulcer forms, the bottom of which is quickly covered with a dense black scab, similar to a coal. The most important feature is that the ulcer is painless, even with an injection, while a large, dense edema develops around it. The nearby lymph nodes become enlarged and the temperature rises. The scab should not be cut, cauterized or opened: this worsens the course and increases the risk of spreading the infection.
- Localization most often on the hands, forearms, face and neck
- A vesicle with dark contents, then an ulcer
- Dense black scab in the center of the lesion
- No pain in the ulcer itself
- Massive swelling of surrounding tissues
- Enlarged regional lymph nodes and fever
Pulmonary and intestinal forms
The pulmonary form begins as a common cold, with low fever and weakness, and after a few days it sharply turns into severe respiratory failure with shortness of breath, chest pain and a drop in pressure. The intestinal form is manifested by vomiting, severe abdominal pain and bloody diarrhea accompanied by fever. Both forms have a high mortality rate, so treatment at the first sign is crucial, especially if the person worked with animal raw materials or ate meat of unknown origin.
- Two-phase course of the pulmonary form with sudden deterioration
- Shortness of breath, chest pain, coughing up blood
- Expansion of the mediastinal shadow on x-ray
- Abdominal pain, vomiting, bloody diarrhea in intestinal form
- Rapid development of shock and sepsis
Diagnostics
The doctor takes into account contact with animals or animal raw materials and the characteristic type of lesion. Material for research is taken from the contents of the vesicle and from under the edge of the scab, and if generalization is suspected, blood is taken. Microscopy, culture and PCR are used. In the pulmonary form, an x-ray or computed tomography scan of the chest is important. Work with the material is carried out in a laboratory with a special security regime, and any suspicion is reported to the sanitary service, since an investigation of the outbreak is required.
- Microscopy and culture of ulcer discharge
- Blood culture for fever and severe illness
- PCR examination of material
- General clinical blood test
- X-ray or CT scan of the chest
- Cerebrospinal fluid analysis for meningeal symptoms
Treatment and prevention
The bacterium is sensitive to antibiotics, and for the skin form, if treatment is started on time, the outcome is usually favorable. The medications and duration of the course are determined by the doctor; in severe forms, therapy is carried out intravenously under conditions of intensive observation. Surgery on an ulcer is contraindicated. People who have been in contact with the source are prescribed prophylactic antibiotics according to the doctor's decision. The main protective measure is to prevent forced slaughter and sale of meat without veterinary control.
- Antibiotics, for severe forms intravenously in the hospital
- Prohibition on opening and excision of scab
- Prophylactic administration of antibiotics to contact persons as prescribed by a doctor
- Vaccination of people from occupational risk groups
- Livestock vaccination and veterinary control of meat
- Refusal to purchase meat without documents and forced slaughter
- Gloves and overalls when working with hides and wool