{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T04:00:06Z","timestamp":1777348806902,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,1,17]]},"abstract":"<jats:p>There has recently been an outbreak of injectional anthrax infection secondary to contaminated heroin use in the UK and Europe. We present a case of a 37-year-old man presenting with pain and swelling in the groin following injection of heroin into the area. He was initially treated for severe cellulitis, however, he failed to respond to appropriate antimicrobial therapy. He went onto develop a widespread rash; it was then that a diagnosis of injectional anthrax infection was considered. Appropriate investigations were initiated including serum sample and tissue biopsy, and the diagnosis was confirmed. Management included extensive surgical debridement and a prolonged course of combination antibiotic therapy. The authors summarise the important steps in diagnosis and the management options in patients presenting with this life-threatening infection.<\/jats:p>","DOI":"10.1136\/bcr-2013-201921","type":"journal-article","created":{"date-parts":[[2014,2,13]],"date-time":"2014-02-13T06:20:33Z","timestamp":1392272433000},"page":"bcr2013201921","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Severe systemic Bacillus anthracis infection in an intravenous drug user"],"prefix":"10.1136","volume":"2014","author":[{"given":"Jessica","family":"Veitch","sequence":"first","affiliation":[{"name":"Countess of Chester NHS Foundation Trust, Chester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anoushka","family":"Kansara","sequence":"additional","affiliation":[{"name":"Countess of Chester NHS Foundation Trust, Chester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Bailey","sequence":"additional","affiliation":[{"name":"Public Health England, Porton Down, Sailsbury, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ildiko","family":"Kustos","sequence":"additional","affiliation":[{"name":"Countess of Chester NHS Foundation Trust, Chester, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,2,13]]},"reference":[{"key":"2025082706490538000_2014.feb13_1.bcr2013201921.1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-012-2541-0"},{"key":"2025082706490538000_2014.feb13_1.bcr2013201921.2","doi-asserted-by":"crossref","unstructured":"Martin GJ Friedlander AM . 2010. Bacillus anthracis (anthrax). In: Mandell GL Bennett JE Dolin R , eds. Mandell Douglas and Bennett's principles and practice of infectious diseases. 7th edn. Churchill Livingston Elsevier 2715\u201331.","DOI":"10.1016\/B978-0-443-06839-3.00208-3"},{"key":"2025082706490538000_2014.feb13_1.bcr2013201921.3","unstructured":"Louisiana State University. School of Vetinary Medicine. World anthrax data site, 2003. http:\/\/www.vetmed.lsu.edu\/whocc\/mp_world.htm (accessed 30 Mar 2012)."},{"key":"2025082706490538000_2014.feb13_1.bcr2013201921.4","unstructured":"Health Protection Scotland. Interim clinical guidance for the management of suspected anthrax in drug user . http:\/\/www.documents.hps.scot.nhs.uk\/giz\/anthrax-outbreak\/clinical-guidance-for-use-of-anthrax-immune-globulin-v12-1-2010-03-19.pdf (accessed 15 Oct 2013)."},{"key":"2025082706490538000_2014.feb13_1.bcr2013201921.5","doi-asserted-by":"crossref","unstructured":"Martin GJ Friedlander AM . 2010. Anthrax as an agent in bioterrorism. In: Mandell GL Bennett JE Dolin R , eds. Mandell Douglas and Bennett's principles and practice of infectious diseases. 7th edn. Churchill Livingston Elsevier, 3983\u201392.","DOI":"10.1016\/B978-0-443-06839-3.00325-8"},{"key":"2025082706490538000_2014.feb13_1.bcr2013201921.6","first-page":"843","article-title":"Injection Anthax\u2014a new outbreak in heroin users","volume":"109","author":"Grunow","year":"2012","journal-title":"Dtsch \u00c4rztebl Int"},{"key":"2025082706490538000_2014.feb13_1.bcr2013201921.7","unstructured":"Health Protection Scotland. An outbreak of anthrax among drug users in Scotland, December 2009 to December 2010 . A report on behalf of the National Anthrax Outbreak Control Team. 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