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Peer reviewedOpen accessAnthrax

Periorbital anthrax after soil-contaminated trauma mimicking necrotizing infection: a case report with diagnostic and reconstructive challenges

Journal of Ophthalmic Inflammation and Infection·

Farshad Afshar, Bahram Eshraghi, Alireza Ramezani Majd, Mohammad Sadegh Khalilian, Ali Aghajani

DOI
10.1186/s12348-026-00640-8
PMID
PMCID
OpenAlex
Study type
Journal article
Publisher
Springer Science and Business Media LLC
Article type
journal-article
Integrity
current

Why this research matters now

The case indicates that cutaneous anthrax should be considered even outside typical zoonotic exposures when wounds are contaminated with soil, and that early Gram stain plus molecular diagnostics can be decisive when cultures are negative. It also illustrates the value of combined antimicrobial, debridement, and oculoplastic reconstructive pathways for severe periocular disease.

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Structured evidence summary

Research question

The report examines how periorbital cutaneous anthrax following a non-zoonotic, soil-contaminated trauma can be recognized and distinguished from necrotizing periocular infection, and how its diagnostic and reconstructive management should proceed.

Study design

A single-patient case report with diagnostic workup, staged surgical management, and delayed reconstructive follow-up.

Population and setting

A 46-year-old male construction worker who developed periorbital anthrax after a soil-contaminated iron-rod abrasion, with no documented animal exposure, managed in a hospital setting capable of ophthalmology and reconstructive surgery.

Main findings

Periorbital anthrax presented with fulminant necrosis and massive non-pitting edema that mimicked necrotizing fasciitis. Empirical broad-spectrum antibiotics rapidly sterilized cultures, and early Gram staining offered a key microbiological clue. RT-PCR targeting pagA and cap genes confirmed Bacillus anthracis, enabling anthrax-directed therapy. Full-thickness skin grafting at six months corrected the resulting cicatricial ectropion.

Public-health relevance

The case indicates that cutaneous anthrax should be considered even outside typical zoonotic exposures when wounds are contaminated with soil, and that early Gram stain plus molecular diagnostics can be decisive when cultures are negative. It also illustrates the value of combined antimicrobial, debridement, and oculoplastic reconstructive pathways for severe periocular disease.

Important limitations

This summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation, and the report itself is a single case with no comparative or epidemiological data.

GIDS interpretation

The article sits within anthrax-related diagnostics and One Health topics and could aid reviewer discoverability of non-zoonotic, soil-associated cutaneous anthrax presentations; any connection to a live surveillance signal is not established from the supplied evidence.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 8 auditable classifier relationships to diseases, places, topics, and study design.

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