Oropharyngeal Anthrax
Incubation Period	Usually 1-7 days

Typical Signs/Symptoms	Initial phase Fever and marked unilateral or bilateral neck swelling caused by regional lymphadenopathy Severe throat pain and dysphagia Ulcers at the base of the tongue, initially edematous and hyperemic	Subsequent phase Ulcers may progress to necrosis Swelling can be severe enough to compromise the airway
Laboratory	Coordinate all aspects of testing, packaging, and transporting with public health laboratory/LRN. Obtain specimens appropriate to system affected: blood (essential) throat	Clues to diagnosis Aerobic blood culture growth of large, gram-positive bacilli provides preliminary identification of Bacillus species.

Treatment (See Inhalational Anthrax Treatment Protocol for specific therapy)	Obtain specimens for culture BEFORE initiating antimicrobial therapy. Do NOT use extended-spectrum cephalosporins or trimethoprim/sulfamethoxazole because anthrax may be resistant to these drugs. Supportive care including controlling ascites
Precautions	Standard contact precautions