Anthrax surgery

Anthrax Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Anthrax from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Chest X Ray

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Anthrax surgery On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Anthrax surgery

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Anthrax surgery

CDC on Anthrax surgery

Anthrax surgery in the news

Blogs on Anthrax surgery

Directions to Hospitals Treating Anthrax

Risk calculators and risk factors for Anthrax surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

## Overview

[edit | edit source]

## Anthrax Surgery

[edit | edit source]

Surgery for cutaneous anthrax can lead to dissemination and poor outcome. Surgery is contraindicated for acute disease, with the exception of tracheotomy for airway obstruction and surgical intervention for large or circumferential extremity lesions causing compartment syndrome.

Surgery may be indicated for gastrointestinal anthrax to identify and address potentially fatal complications, such as bowel ischemia, necrosis, and perforation.[1]

For injection anthrax, surgery is used to obtain diagnostic specimens to differentiate the infection from necrotizing fasciitis and to remove the necrotic nidus of infection, which may be a toxin and spore reservoir. Surgery for injection anthrax should be more limited than that for necrotizing fasciitis, and resection should be performed only to healthy tissue. Compression of soft tissues can be released by incision, excision, or fasciotomy and might be required for treatment of compartment syndrome.[2]

### Procedures

[edit | edit source]

Drainage of pleural fluid and ascites is believed to improve survival by reducing the toxin level and by decreasing mechanical lung compression. These data support the need for early and aggressive drainage of any clinically or radiographically apparent pleural effusions; chest tube drainage is recommended over thoracentesis because many effusions will require prolonged drainage. [3]

Thoracotomy or video-assisted thoracic surgery might be required to remove gelatinous or loculated collections. Ascites should also be drained and monitored for reaccumulation.[3]

## References

[edit | edit source]

1. ↑ Binkley CE, Cinti S, Simeone DM, Colletti LM (2002). "Bacillus anthracis as an agent of bioterrorism: a review emphasizing surgical treatment". Ann Surg. 236 (1): 9–16. PMC 1422543. PMID 12131080.CS1 maint: Multiple names: authors list (link) CS1 maint: PMC format (link)
2. ↑ Knox D, Murray G, Millar M, Hamilton D, Connor M, Ferdinand RD; et al. (2011). "Subcutaneous anthrax in three intravenous drug users: a new clinical diagnosis". J Bone Joint Surg Br. 93 (3): 414–7. doi:10.1302/0301-620X.93B3.25976. PMID 21357967.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
3. ↑ 3.0 3.1 "Centers for Disease Control and Prevention Expert Panel Meetings on Prevention and Treatment of Anthrax in Adults".