Blindness due to Cutaneous Anthrax

1
Erviana Dwi Nurhidayati dan 2Yudha Nurdian

1 Student,
Faculty of Medicine, University of Jember, Indonesia 2 Faculty of Medicine, University of Jember, Indonesia
Corresponding Author: ervianadn20@gmail.com; 152010101072@students.unej.ac.id

Abstract
Background
Anthrax is an infectious zoonotic disease caused by Bacillus anthracis bacteria. This bacteria
is able to produce an endospora that lasts for decades inside the soil and thus becomes an
infection source in endemic areas. It is transmitted to humans via infected animals and infected
animal products. Risk factors include the slaughter, skinning, and processing of infected animal
products. Anthrax is a worldwide disease of domesticated and wild animals that secondarily
may infect humans. Estimates of worldwide cases vary widely, but it is estimated by the World
Health Organization that there are between 2,000 and 20,000 human cases per year. The
incubation period was between 1 and 17 days usually 2-7 days. Anthrax has three different
clinical forms: cutaneous, gastrointestinal, and pulmonary. At present, cutaneous anthrax cases
account for 95 percent of human cases of anthrax. Cutaneous anthrax starts with a small pruritic
papule that grows in size within 24 to 48 hours. This turns into an ulcer surrounded by vesicles.
The middle of each vesicle is dished and filled with fluid. The lesion expands, as it is
surrounded by an erythematous area. The disease characteristics include non-pitting edema and
a black, necrotic, and indolent cutaneous lesion with a central eschar. Lesions are mostly found
on the upper extremities, face and neck. They may also be seen occasionally on the eyelid,
oropharynx, dorsal area, and meninx. The eyelid involvement is rarely seen. The main
complication of eyelid anthrax is cicatricial ectropion. The eschar that develops in 7 to 10 days
leads to scarring and cicatricial ectropion. Moreover a lesion on the eyelid may result in
exophthalmos, optic atrophy, and panophthalmitis. Cutaneous anthrax developed on the upper
and lower eyelid, leading to reported vision loss and the fatal is cause blindness.

Conclusion
Anthrax is a decremental, global zoonotic infection. Early diagnosis and accurate treatment are
essential. Black necrotic eschar tissue is pathognomonic for anthrax. Eyelid anthrax is a rare
form of cutaneous anthrax. Eyelid complications were included cicatricial ectropion, corneal
scars and palpebral symphysis. Moreover a lesion on the eyelid may result in exophthalmos,
optic atrophy, and panophthalmitis. This complication can cause vision loss and the fatal is
cause blindness.

References
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Parlak, E., Parlak, M., and Doğanay, M. 2015. A Rare Cause of Blindness: Cutaneous Anthrax.
Acta Medica Mediterranea, 31: 1299-1302.

Parlak, E., Erturk, E., Erol, S., Parlak, M., and Ozkurt, Z. 2016. Cutaneous Anthrax on Eyelids
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