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Cutaneous anthrax
  1. GOMATHY SETHURAMAN,
  2. DEVINDER M THAPPA,
  3. KALIAPERUMAL KARTHIKEYAN
  1. Department of Dermatology and Sexually Transmitted Diseases
  2. Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)
  3. Pondicherry 605 006, India

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    A 20 year old woman grazing goats presented with a five day history of haemorrhagic bullae on her face. The individual lesion started as a small pruritic but painless papule that had enlarged and evolved into the present lesion. She did not have any systemic complaints. The source of infection was traced and found to be infected goats; some of them were dying. Examination revealed three distinct lesions each consisting of haemorrhagic eschar surrounded by small satellite vesicles and brawny non-pitting oedema (see fig 1). Gram staining of a vesicle fluid smear from the cutaneous lesion showed large Gram positive rods suggestive ofBacillus anthracis. Culture from the vesicle fluid confirmed our diagnosis. The differential diagnosis of cutaneous leishmaniasis had been considered but was ruled out on laboratory investigations. The patient was started on crystalline penicillin in the dosage of two million units, intravenously six hourly for 14 days. Complete resolution of the lesion occurred within two weeks.

    Figure 1

    Six day old lesion (reproduced with the patient's permission).

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