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Volume 20, Number 9—September 2014
CME ACTIVITY - Synopsis

Confirmed Bacillus anthracis Infection among Persons Who Inject Drugs, Scotland, 2009–2010

Malcolm Booth1, Lindsay Donaldson1, Xizhong Cui, Junfeng Sun, Stephen Cole, Susan Dailsey, Andrew Hart, Neil Johns, Paul McConnell, Tina McLennan, Benjamin Parcell, Henry Robb, Benjamin Shippey, Malcolm Sim, Charles Wallis, and Peter Q. EichackerComments to Author 
Author affiliations: Glasgow Royal Infirmary, Glasgow, Scotland, UK (M. Booth, L. Donaldson, A. Hart); National Institutes of Health, Bethesda, Maryland, USA (X. Cui, J. Sun, P.Q. Eichacker); Ninewells Hospital, Dundee, Scotland, UK (S. Cole, B. Parcell); Victoria Infirmary, Glasgow (S. Dailsey); Queen Margaret and Victoria Hospitals, Dumfermline, Scotland, UK (N. Johns, B. Shippey); Crosshouse Hospital, Kilmarnock, Scotland, UK (P. McConnell); Hairmyres Hospital, East Kilbride, Scotland, UK (T. McLennan); Forth Valley Royal Hospital, Larbert, Scotland, UK (H. Robb); Western Infirmary, Glasgow (M. Sim); Western General Hospital, Edinburgh, Scotland, UK (C. Wallis)

Main Article

Table 4

Types of initial surgery and tissue findings on gross examination for persons who inject drugs and had Bacillus anthracis Infection, Scotland, UK, 2009–2010*

Patient no.† Surgery
Gross tissue findings at surgery
Debride Fasciotomy Thigh ex Laparotomy Incision
drainage Excessive
edema Necrotic
tissue Excessive
bleeding Fasciitis Liquefied
necrosis
Survivor‡ 5/11 (45) 4/11 (36) 1/11 (9) 0/11 (0) 1/11 (9) 5/9 (56) 7/11 (64) 1/11 (9) 1/10 (10) 1/10 (10)
1 + + +
2 + + +
3 + + +
4 + +
5 + +
7 + + +
10 +
12 + NA + +
13 + + +
14 +
15

+




NA
+

NA
NA
Nonsurvivor‡ 4/5 (80) 0/5 0/5 1/5 (20) 0/5 (0) 5/5 (100) 3/5 (60) 4/5 (80)§ 2/4 (50) 1/4 (25)
3 + + + + +
4 + + + + +
6 + + + + NA NA
8 + +
9



+


+

+

+
Total 9/16 (56) 4/16 (25) 1/16 (6) 1/16 (6) 1/16 (6) 10/14 (71) 10/16 (63) 5/16 (31) 3/14 (21) 2/14 (14)

*Debride, debridement; thigh ex., thigh exploration; +, type of surgery or tissue finding performed or noted; –, type of surgery or tissue finding not performed or noted; NA, observation not available.
†Patients are numbered in the order in which they sought care.
‡No. (%) patients with the type of surgery or finding/total no. patients for whom data were reported.
§For proportion of positive responses by survivors vs. nonsurvivors for whom data were reported, p<0.05.

Main Article

1These authors contributed equally to this article.

Page created: August 15, 2014
Page updated: August 15, 2014
Page reviewed: August 15, 2014
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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