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Cutaneous Anthrax on Eyelid With Malign Edema

Şensoy, Gulnar MD; Şayli, Tulin R. MD; Çayr, Atilla MDı; Kanmaz, Gozde MD; Tunç, Bahattin MD

Infectious Diseases in Clinical Practice: July 2009 - Volume 17 - Issue 4 - p 276-278
doi: 10.1097/IPC.0b013e3181917868
Case Reports

Anthrax, caused by the gram-positive, spore-forming bacterium Bacillus anthracis, is essentially a disease of herbivorous animals. Cutaneous anthrax is the most common form of the disease and usually develops on exposed skin sites. Eyelid anthrax is one of the rare cause of preseptal cellulitis and can lead to serious complications such as cicatrization, ectropion, and even blindness. A 5-year-old girl admitted to the hospital with complaints of swelling on the left eyelid and fever after a bee sting 3 days before. There was a vesicular lesion on the left lower eyelid. Edema rapidly increased and spread to the left cheek and the forehead, and a malign edema picture has occurred. Anthrax was diagnosed with development of black eschar with surrounding edema. Anthrax was also diagnosed in her mother's index finger. Deepened history revealed that family members had eaten the meat of a sick animal. Bacillus anthracis was isolated from the culture of animal meat at the local health institution. The patient was treated with intravenous ciprofloxacin successfully except ectropion. Although it is a rare disease in humans, anthrax should be considered in the differential diagnosis of preseptal cellulitis to save the life and prevent serious complications.

From the Ministry of Health, Ankara Dışkapı Children's Hospital Education and Investigation Hospital, Ankara, Turkey.

Reprints: Gozde Kanmaz, MD, M. H. Ankara Diskapi Children's Research Hospital, Ankara, Turkey. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.