Pulmonary anthrax is an infectious disease of the lungs caused by Bacillus anthracis, primarily primary pulmonary anthrax, caused by inhalation of dust or small airborne particles with large numbers of Bacillus anthracis buds through the respiratory tract and, in rare cases, secondary to cutaneous anthrax. Pulmonary anthrax is a category B infectious disease under the Prevention and Control of Infectious Diseases Law of the People’s Republic of China, which provides for the adoption of preventive and control measures for category A infectious diseases. The main manifestations are haemorrhagic bronchitis, lobar pneumonia, highly gelatinous oedema of the mediastinum, highly enlarged bronchial and mediastinal lymph nodes, haemorrhagic infiltrates, and possible involvement of the pleura and pericardium.
The diagnosis of pulmonary anthrax relies on epidemiological history, clinical signs and routine tests, chest CT and laboratory tests, including isolation of Bacillus anthracis from patient samples or positive tests for specific antibodies, antigens or nucleic acids. Once this anthrax is diagnosed, it needs to be reported promptly and patients need to be strictly isolated and close contacts and co-exposed persons need to be managed. Pulmonary anthrax occurs throughout the year, mostly in winter and spring, and patients are most often found in pastoral areas, where it is endemic.