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Anthrax — SCE Infectious Diseases MCQ

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ModerateInfection Prevention & ControlAnthraxSCE Infectious Diseases

A 55-year-old farmer from Herefordshire presents with a painless papule on his hand that progresses to a depressed black eschar surrounded by non-pitting oedema. He recently handled animal hides. Gram stain of fluid from beneath the eschar shows large Gram-positive bacilli in chains surrounded by a capsule. What is the diagnosis and treatment?

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Correct answer: B — Cutaneous anthrax; oral Ciprofloxacin 500 mg BD for 7 days

Painless black eschar with surrounding gelatinous oedema in a farm worker handling animal products, with large Gram-positive bacilli in chains with capsule, is classic cutaneous anthrax (Bacillus anthracis). Uncomplicated cutaneous anthrax is treated with oral Ciprofloxacin 500 mg BD (or Doxycycline 100 mg BD) for 7 days. Systemic anthrax (inhalational, GI, or cutaneous with systemic features) requires IV combination therapy. Anthrax is a notifiable disease — urgent UKHSA notification is required.

Reference: UKHSA 2024 – Anthrax guidelines; WHO 2022 – Anthrax management