Anthrax of the pharynx: causes, symptoms, diagnosis, treatment

In 1939, the Italian doctor R. Vacareza first published the results of observation of a patient with isolated anthrax lesion of the pharynx. In the same year, similar publications appeared in Romania (I. Baltcanu, N. Franke, N. Costinescu). V. I. Voyachek (1953) wrote in the "Fundamentals of Otorhinolaryngology": "Anthrax is observed on the tonsils and epiglottis. Histologically, it is fibrinous-diphtheritic tonsillitis. There is no increase in temperature, which distinguishes it from other types of acute tonsillitis with fibrinous plaque. The diagnosis is based on bacteriological examination (anthrax bacilli are found in the cells). Sources of infection are work with the skins of infected animals."

The cause of anthrax of the throat. The causative agent of the infection is Vas. anthracis - a large gram-positive rod. In a living organism, the pathogen exists in a vegetative form, in the environment it forms extremely stable spores. The entry gate of the pathogen is usually damaged skin, less often the mucous membrane of the respiratory tract and the gastrointestinal tract. Hence - three clinical forms of the disease - cutaneous, intestinal and pulmonary. There is also a fourth primary septic form, when the generalization of the process occurs without previous local changes.

Pathogenesis of anthrax of the pharynx. Without going into details of the pathogenesis, pathological anatomy and other aspects of this disease, which belongs to the group of especially dangerous infections, information about which can be found in specialized literature, we note that the entry gates for primary anthrax lesions of the pharynx are the palatine tonsils and the mucous membrane of the pharynx. At the site of infection, pronounced edema of the mucous membrane and submucous layer, a significant increase in the palatine tonsils, which are covered with a fibrinous exudate of gray color of a diphtheroid type, develop. The edematous and hyperemic mucous membrane of the back wall of the pharynx is covered with bubbles of different sizes, reaching the size of a pea. Spreading to the laryngopharynx, the edema causes hoarseness and difficulty breathing. Regional lymph nodes, reaching the size of a walnut, react to the inflammatory process in the pharynx. They do not fuse together, are dense, painless, and are tightly fixed to the underlying tissues. Vascular damage manifests itself in hemorrhages both in the mucous membrane and in the deeper tissues of the pharynx. In the area of hemorrhages, a necrotic process and tissue decay develop.

Immunity after the disease is stable. Human immunity to anthrax is ensured by active immunization with the STM anthrax vaccine.

The diagnosis is established on the basis of the patient's professional affiliation with cattle breeding, furriery, as well as contact with an anthrax patient, stay in an endemic focus, etc. The presence of pronounced swelling of the neck and chest, echymatous spots on the mucous membrane of the pharynx, fibrinoid deposits on enlarged tonsils with a scanty subjective and general clinical objective picture, different from vulgar tonsillitis, increase the likelihood of primary anthrax tonsillitis. The final diagnosis is established on the basis of a positive intradermal allergic test with a drug obtained from anthrax bacteria (anthraxin). Of the serological methods, immunofluorescence reactions and Ascoli's thermoprecipitation are used. Bacterioscopy of the infected material gives approximate results.

Treatment of anthrax of the pharynx: anti-anthrax y-globulin (single dose in Bezredke), antibiotics, prednisolone, blood substitutes, detoxification drugs. Treatment is carried out in a specialized infectious diseases department.

The prognosis for the cutaneous form is usually favorable. For other forms, and especially septic, it is questionable.

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