Case 18 CONFIRMED

On October 17, a 51-year-old woman developed a large pimple on her forehead with erythema and swelling. On October 18, the lesion enlarged, was slightly painful, nonpruritic, and drained a small amount of yellowish fluid. She sought medical care, cervical and preauricular lymphadenopathy was noted on physical examination, and she was treated with ciprofloxacin. The lesion progressed and ulcerated. On October 22, she presented to an emergency department and was admitted with a diagnosis of cellulitis. On admission, she was afebrile with normal vital signs and had a swollen right face and eyelid and enlarged right anterior cervical nodes. Intravenous ciprofloxacin for cutaneous anthrax was started. On October 24, the ulcer was biopsied and debrided. Biopsy specimens were positive for B. anthracis by PCR and IHC. The patient improved and was discharged on October 27 on oral ciprofloxacin. The patient worked as a bookkeeper and reported receiving no unusual or powder-containing mail at home or work. She had made no visits to any post offices in several months. Finding suggest she contracted the infection through her mail. Authorities have speculated that her mail was contaminated during processing at a nearby Postal Service center.

Click for news account of un-named case (10/30/01)

Click for local news account of Linda Burch (11/3/01)

Click for news account of investigation of un-named case (11/11/01)

Click for news account of Linda Burch (12/26/01)