CT and MRI findings of anthrax meningoencephalitis; Case report

Anthrax is a zoonotic infection which spreads by handling or eating infected product of infected animals and by inhalation of Bacillius anthrax spores (1). Meningoencephalitis is a rare clinical condition of anhtrax which almost has an aggressive clinical course and fatal outcome despite aggressive antibiotic therapy and intensive care supports. Anthrax is diagnosed by detecting B. anthracis in samples taken from blood, spinal fluid, skin lesions, or respiratory secretions and by growth of bacteria in cultures (1, 2). Although this progressive radiological and clinical antity mostly occurs secondary to skin, pulmonary and gastrointestinal involvement through hematogenous and lymphogenous route, in rare cases primary source cannot be detected. Anthrax meningoencephalitis occurs in less than 5% of all patients with anthrax (3). Most common symptom and findings are nonspecific which include headache, confusion, muscle weakness, seizures, neck rigidity, delirium and coma. Although a history of handling or eating meats of infected animals, high-risked jobs such as butchers, progressive neurological symptoms and living in epidemic areas may be suggestive for anthrax menengoencephalitis (3). Anthrax meningoencephalitis usually exhibits as hemorrhagic encephalitis. Treatment of the disease is composed of combined antibiotic therapy and intensive care. As it is a fatal disease and common in eastern of our country we present a primary source unknown anthrax meningoencephalitis case with CT and MRI findings.