Anthrax: From antiquity and obscurity to a front-runner in bioterrorism

Anthrax infection is caused by Bacillus anthracis, a large gram-positive, rod-shaped bacterium found in soil around the world. Although anthrax is usually a disease of grazing animals, human contact with animal products, such as hides, hairs, and wool that are contaminated with anthrax endospores can result in clinical infection with cutaneous, inhalational, gastrointestinal, and neurologic manifestations. Anthrax has recently become a front-runner in potential bioterrorism weapons. This article presents a brief history of anthrax, discusses different clinical presentations of anthrax, reviews the clinical characteristics that can be used to recognize inhalational anthrax victims, discusses current diagnostic and treatment modalities, and provides an overview of emerging and investigational therapies and vaccines.