Question-5 {no more questions today-I promise(;-) - alveoli

[ArchivalUser]

5} What are the clinical consequences of Bacillus anthracis endospores coming in contact with an abrasion on the arm of a rancher?

A) The endospores germinate in the skin, gain access to the blood, and cause death due to massive sepsis.
B) The endospores germinate in the skin, gain access to the lymphatic system, and cause significant axillary lymphadenopathy.

C) The endospores germinate in the skin, gain access to the blood, and cause fatal pneumonia.

D) The endospores are engulfed by dermal macrophages and are transported by them to the blood, at which point they germinate; the ensuing bacterial proliferation causes death due to massive sepsis.

E) The lesion that forms undergoes central necrosis and surrounding edema.

[ArchivalUser]

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[ArchivalUser]

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[ArchivalUser]

Perfect!!Great!

Picture Link:
http://dermatlas.med.jhmi.edu/derm/Index...1787075851

E) The lesion that forms undergoes central necrosis and surrounding edema.

Feedback: Explanation:The endospores of B. anthracis, a gram-positive organism, are generally hearty and difficult to eradicate. The endospores are introduced into the body via the skin (abrasion or cut), inhalation, or ingestion or they phagocytosed by macrophages and carried to regional lymph nodes. Germination occurs in the lymph node; bacteria released into the blood stream cause massive septicemia, which is almost always fatal. When anthrax endospores are ingested or inhaled or if bacteria reach the meninges, fatality is common. However, 80 to 90% of cutaneous anthrax is self-limited. The primary skin lesion is a pruritic papule that appears 3 to 5 days after the introduction of endospores. One to two days later the lesion forms a vesicle that eventually undergoes central necrosis, giving a typical black eschar. The eschar is surrounded by edema and purplish vesicles. This so-called malignant edema can, if present in the neck and thoracic region, lead to a tracheal compromise. Antibiotic treatment for cutaneous anthrax is recommended but probably not required.