Volume 12, Number 3—March 2006 Cutaneous Anthrax, Belgian
Traveler To the Editor: Anthrax is a rare zoonotic disease among
travelers. The clinical spectrum includes cutaneous lesions,
respiratory anthrax, pharyngeal inflammation, gastrointestinal
infection, septicemia, and meningitis. Interest in anthrax
increased after the bioterrorist attacks in the United States in
2001. The following case history describes a cutaneous infection
suspected to be anthrax in a tourist who had indirect contact
with dead mammals in a disease-endemic area. After indirect
contact with dead antelopes and a hippopotamus in Botswana, an
acute necrotic lesion developed on a finger of a 31-year-old,
healthy, female Belgian woman. The lesion became covered with a
black crust, followed by massive swelling of the hand and arm.
The clinical aspect and history strongly suggested cutaneous
anthrax. This diagnosis was supported by seroconversion to
protective antigen of Bacillus anthracis and the presence of
antibodies against lethal factor.