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A vaccine is available to protect individuals from anthrax. However, unlike most routine vaccines, the current anthrax vaccine is unique in both its formulation and the protocols dictating who receives it. Centers for Disease Control and Prevention . “Anthrax: Medical Care: Prevention: Antibiotics.” http://www.cdc.gov/anthrax/medical-care/prevention.html. Accessed Sept 14, 2016. The vaccine is administered through five intramuscular injections over a period of 18 months, followed by annual boosters. The US Food and Drug Administration (FDA) has only approved administration of the vaccine prior to exposure for at-risk adults, such as individuals who work with anthrax in a laboratory, some individuals who handle animals or animal products (e.g., some veterinarians), and some members of the United States military. The vaccine protects against cutaneous and inhalation anthrax using cell-free filtrates of microaerophilic cultures of an avirulent, nonencapsulated strain of B. anthracis . Emergent Biosolutions. AVA (BioThrax) vaccine package insert (Draft). Nov 2015. http://www.fda.gov/downloads/biologicsbloodvaccines/bloodbloodproducts/approvedproducts/licensedproductsblas/ucm074923.pdf. The FDA has not approved the vaccine for routine use after exposure to anthrax, but if there were ever an anthrax emergency in the United States, patients could be given anthrax vaccine after exposure to help prevent disease.

  • What is the characteristic feature of a cutaneous anthrax infection?

Bacterial infections of the skin

Bacterial infections of the skin can cause a wide range of symptoms and syndromes, ranging from the superficial and relatively harmless to the severe and even fatal. Most bacterial skin infections can be diagnosed by culturing the bacteria and treated with antibiotics. Antimicrobial susceptibility testing is also often necessary because many strains of bacteria have developed antibiotic resistance. [link] summarizes the characteristics of some common bacterial skin infections.

Table titled: Bacterial Infections of the Skin. Columns: Disease, Pathogen, Signs and Symptoms, Transmission, and Antimicrobial Drugs. Acne, Propionibacterium acnes, Comedones (whiteheads, blackheads); papules, pustules, nodules, or pseudocysts, Not transmissible; clogged pores become infected by normal skin microbiota (P. acnes), Erythromycin, clindamycin. Anthrax (cutaneous), Bacillus anthracis, Eschar at site of infection; may lead to septicemia and can be fatal, Entry of B. anthracis endospores through cut or abrasion, Penicillin, erythromycin, or tetracycline. Cellulitis, Streptococcus pyogenes, Localized inflammation of dermis and hypodermis; skin red, warm, and painful to the touch, Entry of S. pyogenes through cut or abrasion, Oral or intravenous antibiotics (e.g., penicillin). Erysipelas, S. pyogenes, Inflamed, swollen patch of skin, often on face; may be suppurative, Entry of S. pyogenes through cut or abrasion, Oral or intravenous antibiotics (e.g., penicillin). Erythema nodosum, S. pyogenes, Small red nodules, often on shins, Associated with other streptococcal infection, None or anti-inflammatory drugs for severe cases. Impetigo, Staphylococcus aureus, S. pyogenes, Vesicles, pustules, and sometimes bullae around nose and mouth, Highly contagious, especially via contact Topical or oral antibiotics. Necrotizing fasciitis, S. pyogenes, Klebsiella, Clostridium, others, Infection of fascia and rapidly spreading tissue death; can lead to septic shock and death, Entry of bacteria through cut or abrasion, Intravenous broad-spectrum antibiotics. Otitis externa, Pseudomonas aeruginosa, Itching, redness, discomfort of ear canal, progressing to fever, pain, swelling, P. aeruginosa enters ear canal via pool or other water, Acidic ear drops with antibiotics, antifungals, steroids. Staphylococcal scalded skin syndrome (SSSS), S. aureus, Erythema and severe peeling of skin Infection of skin and mucous membranes, especially in children, Intravenous antibiotics, fluid therapy. Wound infections, P. aeruginosa, others, Formation of biofilm in or on wound. Exposure of wound to microbes in environment; poor wound hygiene, Polymyxin B, gentamicin, fluoroquinolones, topical anti-biofilm agents.

Bacterial conjunctivitis

Like the skin, the surface of the eye comes in contact with the outside world and is somewhat prone to infection by bacteria in the environment. Bacterial conjunctivitis ( pinkeye ) is a condition characterized by inflammation of the conjunctiva, often accompanied by a discharge of sticky fluid (described as acute purulent conjunctivitis) ( [link] ). Conjunctivitis can affect one eye or both, and it usually does not affect vision permanently. Bacterial conjunctivitis is most commonly caused by Haemophilus influenzae , but can also be caused by other species such as Moraxella catarrhalis , S. pneumoniae, and S. aureus . The causative agent may be identified using bacterial cultures, Gram stain, and diagnostic biochemical, antigenic, or nucleic acid profile tests of the isolated pathogen. Bacterial conjunctivitis is very contagious, being transmitted via secretions from infected individuals, but it is also self-limiting. Bacterial conjunctivitis usually resolves in a few days, but topical antibiotics are sometimes prescribed. Because this condition is so contagious, medical attention is recommended whenever it is suspected. Individuals who use contact lenses should discontinue their use when conjunctivitis is suspected. Certain symptoms, such as blurred vision, eye pain, and light sensitivity, can be associated with serious conditions and require medical attention.

Practice MCQ 4

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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