Human Cutaneous Anthrax—North Carolina, 1987
ON JULY 10,1987, a 42-year-old male maintenance worker at a North Carolina textile mill noticed a small, red, pruritic, papular lesion on his right forearm. Over the next week, the lesion became vesiculated and then developed a depressed black eschar with surrounding edema. On July 18, 24 hours after beginning treatment with an oral cephalosporin and a topical antifungal agent, he was hospitalized with worsening edema, pain, fever, and chills. Cutaneous anthrax was diagnosed. After the patient was treated with intravenous ampicillin and cephalosporins, his condition improved, and he was discharged on a regimen of oral cephalosporin. Cultures of blood and wound tissues were negative. An electrophoretic immunotransblot assay for antibody to anthrax antigens demonstrated a titer of 512 to anthrax protective antigen and lethal factor.1 The patient's lesion healed with residual local scarring, and he returned to work in late August 1987.The