When bioterrorism strikes: diagnosis and management of inhalational anthrax

In October and November, 2001, reports of patients with inhalational anthrax reacquainted the public with this ancient disease and introduced the harsh reality of a bioterrorist act. Bacillus anthracis, a rod-shaped, spore-forming bacterium, primarily infects herbivores. Humans traditionally have acquired the disease from occupational or agricultural exposure to infected animals and animal products. Recent events saw the intentional release of anthrax spores, using the U.S. postal system as an unlikely and unwilling agent. Cutaneous disease, pulmonary disease, and gastrointestinal anthrax are the known clinical manifestations of anthrax. Inhalational anthrax has the highest mortality and is the main focus of this report.