Anthrax

New methods of treating anthrax have become of urgent interest following the recent outbreak of anthrax infections and deaths in the United States as a result of terrorism. In anthrax infection, endospores from Bacillus anthra-cis that gain entrance into the body are phagocytosed by macrophages and carried to regional lymph nodes where the endospores germinate inside the macrophages and become vegetative bacteria (17). Computed tomography of the chest was performed on eight recent patients infected with inhala-tional anthrax. Mediastinal lymphadenopathy was present in seven of the eight patients (18). In a recent case report of one patient, the anthrax bacillus was shown to be rapidly sterilized within the blood stream after initiation of antibiotic therapy. However, viable anthrax bacteria were still present in postmortem mediastinal lymph node specimens (19). This case demonstrates the difficulty that drugs have in penetrating the mediastinal lymph nodes. A potential use of liposomes could be for delivery of antianthrax drugs to the mediastinal lymph nodes for therapy or prevention of anthrax extension to the lymph nodes.

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