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Anthrax Nursing Guide

Content reviewed by Ann Dietrich, MD, FAAP, FACEP.

Anthrax Etiology and epidemiology 

Caused by the bacterium Bacillus anthracis, anthrax is an infectious disease found naturally in soil. While it primarily affects wild and domestic animals, humans can become infected through direct or indirect contact with contaminated livestock, inhalation of spores, or consumption of contaminated food or water (CDC, 2020). Person-to-person transmission of anthrax has not been confirmed (Mayo Clinic, 2020). 

Anthrax can manifest in different forms depending on the channel of entry into the body: 

  • Cutaneous anthrax: This occurs when the bacterium enters through a cut or abrasion on the skin. 
  • Inhalational anthrax: This results from inhaling spores. 
  • Gastrointestinal (GI) anthrax: This occurs from ingesting contaminated food or water. 
  • Pharyngeal anthrax: This results from ingestion or inhalation of spores affecting the throat. 

While rare in developed countries, anthrax remains a concern due to its potential use as a bioterrorism agent (Mayo Clinic, 2020). Globally, there are between 2,000 and 20,000 cases annually, though it is rare in the U.S. (Simonsen & Chatterjee, 2021). 

Anthrax Diagnosis 

Diagnosis of anthrax typically involves: 

  • Medical history and physical exam: Key to identifying potential exposure to Bacillus anthracis. 
  • Diagnostic tests: 
  • Gram stain and blood culture: To detect the presence of Bacillus anthracis. 
  • Chest radiography and CT scan: Particularly useful in suspected inhalational anthrax. 
  • Enzyme-linked immunosorbent assay (ELISA): To expose specific antibodies against anthrax. 
  • Lumbar puncture: If meningitis is suspected. 
  • Histologic findings: Can confirm the presence of Bacillus anthracis in tissue samples. 

Management 

Management of anthrax includes both preventive and therapeutic measures: 

  • Vaccination: For individuals at high risk, such as those working with livestock or in certain laboratories. 
  • Avoidance of infected animals: Particularly important in areas where anthrax is known to occur. 
  • Medication adherence: Antibiotics and antitoxins may be prescribed, depending on the type and severity of the infection. 

Anthrax Nursing Care Plan

Nursing considerations 

Assessment 

Signs and symptoms of anthrax vary by form but may include: 

  • Cutaneous anthrax: 
    • Raised, itchy, bumpy skin (resembling an insect bite) that progresses into a painless sore with a black center. 
  • Inhalational anthrax: 
    • Shortness of breath, mild chest discomfort, flu-like symptoms (e.g., headaches, fever), and nausea. 
  • Gastrointestinal anthrax: 
    • Nausea, vomiting, abdominal pain, and painful swallowing. 
  • Pharyngeal anthrax: 
    • Sore throat, swelling of nearby lymph glands, and pain. 

Nursing diagnoses 

  • Ineffective airway clearance 
  • Ineffective breathing pattern 
  • Impaired swallowing 
  • Diarrhea 
  • Impaired tissue integrity 
  • Hyperthermia 

Interventions 

  • Auscultate lungs: Regular monitoring for respiratory changes. 
  • Positioning: Ensure the individual is sitting upright to facilitate breathing. 
  • Monitor bowel movements: To detect and manage diarrhea. 
  • Medication adherence: Ensure the individual follows the prescribed antibiotic regimen. 

Expected outcomes 

  • Improved airway patency: Ensure clear and unobstructed airways. 
  • Effective swallowing: Prevent aspiration and ensure adequate nutrition. 
  • Stable breathing pattern: Maintain normal respiratory function. 
  • Restored tissue integrity: Prevent progression of cutaneous lesions. 
  • Resolution of diarrhea: Return to normal bowel function. 
  • Reduced hyperthermia: Maintain normal body temperature. 

Individual/caregiver education 

  • Proper positioning: Importance of sitting upright to aid breathing. 
  • Coughing and deep breathing exercises: To clear airways and prevent lung infections. 
  • Vaccination benefits: Understanding the role of vaccination in preventing anthrax. 
  • Medication adherence: Emphasize the importance of completing the antibiotic course. 
  • Monitoring skin changes: Recognize when to seek medical attention for worsening symptoms. 

ICD-10 Code for anthrax 

  • A22.9 — Anthrax, unspecified 

FAQs

Additional Information

Content Release Date 

4/1/2022

Content Expiration

12/31/2029

References 

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