The primary lesion is a painless, pruritic papule that appears from one to seven days after inoculation. Within one to two days, small vesicles or a larger, 1 to 2 cm vesicle forms and is filled with clear or serosanguineous fluid. As the vesicle enlarges, satellite vesicles may form. Fluid within the vesicles may contain numerous, large gram-positive bacilli. As the lesion matures, a prominent, non-pitting edema surrounds the lesion. Eventually, the vesicle ruptures, undergoes necrosis, and enlarges, forming an ulcer covered by the characteristic black eschar. Symptoms include low-grade fever, malaise. Regional lympadenopathy is present early on.
Recognition and Management of Anthrax—An Update
Used with Permission from the Center for Public Health and Disasters of California
Search PIER® - Decision Support
ACP Members Only. Decision support for over 460 clinical topics.
Quality Improvement Programs: Our Center for Quality develops programs to bridge the gap between research and practice.
Adult Immunization: Inform, Implement, Immunize: ACP's Immunization Outreach Program
Educators: Let Annals assist you with your teaching activities!
Annals for Educators Alerts include Clinical Practice Points, Quality Improvement, Humanism and Professionalism, and a MKSAP Morning Report question derived from MKSAP 16. Find out more!
Earn ABIM Practice Assessment Points
ACP now offers a variety of ABIM recertification resources to help you earn ABIM Maintenance of Certification Practice Assessment points!
See the resources on our Webpage.