Global & Disaster Medicine

Italy: Unexpected human cases of cutaneous anthrax


Nicastri Emanuele, Vairo Francesco, Mencarini Paola, Battisti Antonio, Agrati Chiara, Cimini Eleonora, Carrara Stefania, D’Arezzo Silvia, Adone Rosanna, Vulcano Antonella, Iannetta Marco, Capone Alessandro, Petrosillo Nicola, Fasanella Antonio, Ippolito Giuseppe, Italian Anthrax Team members. Unexpected human cases of cutaneous anthrax in Latium region, Italy, August 2017: integrated human–animal investigation of epidemiological, clinical, microbiological and ecological factors. Euro Surveill. 2019;24(24):pii=1800685.


Case 1
“……The veterinarian had contaminated his left hand with the animal’s blood during removal of the disposable gloves. Ten days later, on 29 August, he noticed the appearance of two skin lesions on his left hand. As he was affected by psoriasis, he considered them psoriatic lesions and applied topical steroids, but 24 h later, the lesion on the index finger evolved to a black eschar, surrounded by erythema and oedema……
Case 2
A man in his 40s looked for medical care at the local Emergency Department in a city 30 km from Rome, on 25 August and 31 August. He presented with several vesicular lesions on his right forearm and was initially treated with topical steroid therapy and parenteral ceftriaxone (1 g/day)…..
[H]is clinical condition deteriorated….
At admission, he was in critical condition, with relevant bilateral oedema of the upper extremity up to the shoulders, associated with ulcerated and necrotising skin lesions covered by black eschars. He revealed to be a farmworker but did not report any contact or exposure to sick animals. He had worked on a horse farm bordering the one where the anthrax epidemic had occurred…..”


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