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Original Contribution
JAMA. 2002;287(7):869-874. doi: 10.1001/jama.287.7.869

Cutaneous Anthrax Associated With Microangiopathic Hemolytic Anemia and Coagulopathy in a 7-Month-Old Infant

  1. Abigail Freedman, MD;
  2. Olubunmi Afonja, MD;
  3. Mary Wu Chang, MD;
  4. Farzad Mostashari, MD;
  5. Martin Blaser, MD;
  6. Guillermo Perez-Perez, MD;
  7. Herb Lazarus, MD;
  8. Robert Schacht, MD;
  9. Jane Guttenberg, MD;
  10. Michael Traister, MD;
  11. William Borkowsky, MD
  1. Author Affiliations: Departments of Pediatrics (Drs Freedman, Afonja, Chang, Lazarus, Schacht, Guttenberg, Traister, and Borkowsky), Dermatology (Dr Chang), Health (Dr Mostashari), and Medicine (Drs Blaser and Perez-Perez), New York University School of Medicine, New York.

Abstract

A 7-month-old infant with cutaneous anthrax developed severe systemic illness despite early treatment with antibiotics. The infant displayed severe microangiopathic hemolytic anemia with renal involvement, coagulopathy, and hyponatremia. These findings are unusual with cutaneous anthrax, but have been described in illness resulting from spider toxin and may delay correct diagnosis. The systemic manisfestations of the disease persisted for nearly a month despite corticosteroid therapy, but resolved.

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