Severe cutaneous anthrax with systemic complications: a case report

In this case, we describe a severe case of human cutaneous anthrax complicated by secondary generalized form with bacteremia, sepsis, pulmonary involvement, and multiorgan dysfunction in an immunocompetent adult from Kazakhstan. A 31-year-old male presented with a progressive vesicles and bullae lesion on the right forearm associated with fever, extensive edema, following direct contact with a sick animal during slaughter. Wound exudate and blood sample demonstrated the presence of DNA Bacillus anthracis by PCR, and culture test of skin lesion confirmed the diagnosis. Despite early initiation of antimicrobial therapy, the patient developed sepsis, coagulation abnormalities, hepatic dysfunction, and bilateral pneumonia with pleural effusion, necessitating intensive care unit admission and escalation of antimicrobial and supportive treatment. Clinical and laboratory parameters gradually improved, and the patient recovered without late complications. This case highlights the potential for life-threatening systemic progression of cutaneous anthrax, emphasizes the diagnostic value of molecular detection of B. anthracis in blood, and underscores the importance of early recognition, close monitoring, and timely escalation of therapy in patients from endemic areas.