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Fatal cutaneous anthrax in a heroin user

Published online by Cambridge University Press:  04 February 2013

S Meghji ,
O Judd  and
E Carr
S Meghji
Affiliation:
Medical School, University of Leicester, UK
O Judd*
Affiliation:
Department of Otolaryngology, Leicester Royal Infirmary, UK
E Carr
Affiliation:
Department of Otolaryngology, Leicester Royal Infirmary, UK
*
Address for correspondence: Mr Owen Judd, Specialist Registrar in ENT, Department of Otolaryngology, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK Fax: +44 (0)128 352 9129 E-mail: owenjudd@doctors.org.uk
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Abstract

Background and objective:

Cutaneous anthrax usually has a mortality rate of less than 1 per cent. However, since December 2009 there have been more than 13 deaths in the UK due to anthrax-contaminated heroin. We therefore wish to raise clinical awareness of this treatable disease.

Case report:

We describe the case of a heroin user with an equivocal presentation of cellulitis in the neck. Within 36 hours, this led to death due to cutaneous anthrax.

Conclusion:

Whilst cutaneous anthrax remains rare, this case report aims to raise awareness of the fact that the symptoms and signs of this condition in intravenous drug users may not always fit the typical picture.

Keywords

AnthraxSkinHeroinDrug Abuse, Intravenous
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 4 , April 2013 , pp. 423 - 425
Copyright
Copyright © JLO (1984) Limited 2013

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References

1Health Protection Scotland. Interim Clinical Guidance for Management of Suspected Anthrax in Drug Users. In: http://www.hps.scot.nhs.uk/anthrax/documents/clinical-guidance-for-use-of-anthrax-immune-globulin-v12-1-2010-03-19.pdf [1 September 2010]Google Scholar
2Medscape. Anthrax. In: http://emedicine.medscape.com/article/212127-overview [1 September 2010]Google Scholar
3Artenstein, AW. Anthrax: from antiquity to answers. J Infect Dis 2007;195:471–3CrossRefGoogle ScholarPubMed
4Babamahmoodi, F, Aghabarari, F, Arjmand, A, Ashrafi, GH. Three rare cases of anthrax arising from the same source. J Infect 2006;53:175–9CrossRefGoogle ScholarPubMed
5Reece, AS. Clinical implications of addiction related immunosuppression. J Infect 2008;56:437–45CrossRefGoogle ScholarPubMed
6Govitrapong, P, Suttitum, T, Kotchabhakdi, N, Uneklabh, T. Alterations of immune functions in heroin addicts and heroin withdrawal subjects. J Pharm Exp Ther 1998;286:883–9Google ScholarPubMed
7Weed, MR, Carruth, LM, Adams, RJ, Ator, NA, Hienz, RD. Morphine withdrawal dramatically reduces lymphocytes in morphine-dependent macaques. J Neuroimmune Pharm 2006;1:250–9CrossRefGoogle ScholarPubMed
8Somaini, L, Pacini, M, Maremmani, I. Clinical foundations for the use of methadone in patients with infectious diseases. Heroin Addict Relat Clin Probl 2010;12:21–31Google Scholar
9Ramsay, CN, Stirling, A, Smith, J, Hawkins, G, Brooks, T, Hood, J et al. An outbreak of infection with Bacillus anthracis in injecting drug users in Scotland. Euro Surveill 2010;15:article 1CrossRefGoogle ScholarPubMed