Anthraxs

, had not received FDA certification of its new manufacturing process. (5) Although Pasteur had already demonstrated protection of sheep by injection of heat-attenuated B. anthracis cultures in 1881, our current knowledge of immunity to anthrax in humans remains limited.(5).
             Types of B. Anthracis.
             Cutaneous Anthrax.
             Cutaneous anthrax is the most common form of anthrax infection, accounting for 90% to 95% of the cases worldwide and all of the prior cases reported in the United States. Many of the exposures have been occupational and resulted from the handling of infected animals or laboratory materials. (2) Spores are .
             introduced through breaks in the skin; within 3 to 5 days, the skin bears the primary lesion marked by a painless, pruritic papule that 24 to 36 hours later forms an ulcer with accompanying vesicles. The area goes on to become necrotic, forming a black eschar resembling coal.The skin lesion may become .
             secondarily infected, typically with staphylococci or streptococci, leading to .
             purulence and cellulitis. (2) .
             Although 80% to 90% of the cases of cutaneous anthrax are self-limited, associated death results primarily from systemic dissemination and elaboration of exotoxins. (2) In cases of cutaneous anthrax with signs of systemic dissemination, extensive edema, or head and neck involvement, the CDC recommends treatment with intravenous ciprofloxacin along with one or two additional agents with in vitro activity against anthrax, including rifampin, vancomycin, penicillin, ampicillin, chloramphenicol, imipenem, clindamycin, or clarithromycin. Penicillin and ampicillin should not be used alone to treat anthrax because of concerns about beta-lactamase activity. (2) When treated with antibiotics, the death rate of cutaneous anthrax is less than 1%, increasing to 10% to 20% without treatment. (2) .
             Apart from antibiotics, treatment of localized cutaneous anthrax relies on routine local wound care with sterile moist dressings changed regularly, as well as elevation of the affected region to retard edema formation.