Progress of research on anthrax meningitis_West China Medical Journal

Authors：

ZHOU Shaobo ¹ , Dina Haishaer ¹ ,  ZHAO Hongmei ²

1. Department of Clinical Laboratory, the People’s Hospital of China Medical University, the People’s Hospital of Liaoning Province, Shenyang, Liaoning 110015, P. R. China;
2. Department of Hospital Infection Control Office, the People’s Hospital of China Medical University, the People’s Hospital of Liaoning Province, Shenyang, Liaoning 110015, P. R. China;

Corresponding author：

ZHAO Hongmei, Email: 13889299493@126.com

Keywords：

Human anthrax; Bacillus anthracis; meningitis; diagnosis; treatment

DOI：

10.7507/1002-0179.202407045

Video：

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Anthrax is a zoonotic, acute infectious disease caused by Bacillus anthracis. Anthrax meningitis is one of the most dangerous types of anthrax, mostly secondary to cutaneous, intestinal, and pulmonary anthrax, and is a central nervous system infectious disease that is extremely lethal in the absence of timely treatment. This article reviews the clinical characteristics, pathogenesis, diagnosis and treatment of anthrax meningitis, in order to provide some reference for the clinical diagnosis and treatment of anthrax meningitis in China, and to provide reference for the further development of anthrax meningitis research.

Citation： ZHOU Shaobo, Dina Haishaer, ZHAO Hongmei. Progress of research on anthrax meningitis. West China Medical Journal, 2024, 39(8): 1297-1301. doi: 10.7507/1002-0179.202407045 Copy

1.	Bower WA, Hendricks KA, Vieira AR, et al. What is anthrax?. Pathogens, 2022, 11(6): 690.
2.	Albayrak F, Memikoglu O, Kurt O, et al. A case of anthrax meningitis. Scand J Infect Dis, 2002, 34(8): 627-628.
3.	Popescu CP, Zaharia M, Nica M, et al. Anthrax meningoencephalitis complicated with brain abscess - a case report. Int J Infect Dis, 2021, 108: 217-219.
4.	Alam ME, Kamal MM, Rahman M, et al. Review of anthrax: a disease of farm animals. J Adv Vet Anim Res, 2022, 9(2): 323-334.
5.	张海霞. 人兽共患病-炭疽的综合防控. 山东畜牧兽医, 2022, 43(1): 66-69.
6.	Wales A, Mackintosh A. JMM profile: Bacillus anthracis. J Med Microbiol, 2023, 72(8): 1-6.
7.	Koehler TM. Bacillus anthracis physiology and genetics. Mol Aspects Med, 2009, 30(6): 386-396.
8.	Head BM, Rubinstein E, Meyers AF. Alternative pre-approved and novel therapies for the treatment of anthrax. BMC Infect Dis, 2016, 16(1): 621.
9.	Parlak E, Parlak M, Atli SB. Unusual cause of fatal anthrax meningitis. Cutan Ocul Toxicol, 2015, 34(1): 77-79.
10.	Hendricks K, Person MK, Bradley JS, et al. Clinical features of patients hospitalized for all routes of anthrax, 1880-2018: a systematic review. Clin Infect Dis, 2022, 75(Suppl 3): S341-S353.
11.	Kwong KL, Que TL, Wong SN, et al. Fatal meningoencephalitis due to Bacillus anthracis. J Paediatr Child Health, 1997, 33(6): 539-541.
12.	Moayeri M, Leppla SH, Vrentas C, et al. Anthrax pathogenesis. Annu Rev Microbiol, 2015, 69: 185-208.
13.	Ebrahimi CM, Sheen TR, Renken CW, et al. Contribution of lethal toxin and edema toxin to the pathogenesis of anthrax meningitis. Infect Immun, 2011, 79(7): 2510-2518.
14.	Al-Obaidi MMJ, Desa MNM. Mechanisms of blood brain barrier disruption by different types of bacteria, and bacterial-host interactions facilitate the bacterial pathogen invading the brain. Cell Mol Neurobiol, 2018, 38(7): 1349-1368.
15.	Ramarao N, Lereclus D. The InhA1 metalloprotease allows spores of the B. cereus group to escape macrophages. Cell Microbiol, 2005, 7(9): 1357-1364.
16.	Mukherjee DV, Tonry JH, Kim KS, et al. Bacillus anthracis protease InhA increases blood-brain barrier permeability and contributes to cerebral hemorrhages. PloS One, 2011, 6(3): e17921.
17.	van Sorge NM, Ebrahimi CM, McGillivray SM, et al. Anthrax toxins inhibit neutrophil signaling pathways in brain endothelium and contribute to the pathogenesis of meningitis. PloS One, 2008, 3(8): e2964.
18.	Swartz MN. Recognition and management of anthrax — an update. N Engl J Med, 2001, 345(22): 1621-1626.
19.	Yorgancigil B, Demirci M, Unlu M, et al. Anthrax meningitis: case report. Int J Infect Dis, 2001, 5(4): 220-221.
20.	Tasyaran MA, Deniz O, Ertek M, et al. Anthrax meningitis: case report and review. Scand J Infect Dis, 2002, 34(1): 66-67.
21.	Kim HJ, Jun WB, Lee SH, et al. CT and MR findings of anthrax meningoencephalitis: report of two cases and review of the literature. AJNR Am J Neuroradiol, 2001, 22(7): 1303-1305.
22.	Caffes N, Hendricks K, Bradley JS, et al. Anthrax meningoencephalitis and intracranial hemorrhage. Clin Infect Dis, 2022, 75(Suppl 3): S451-S458.
23.	Doganay M, Dinc G, Kutmanova A, et al. Human anthrax: update of the diagnosis and treatment. Diagnostics (Basel), 2023, 13(6): 1056.
24.	Katharios-Lanwermeyer S, Holty JE, Person M, et al. Identifying meningitis during an anthrax mass casualty incident: systematic review of systemic anthrax since 1880. Clin Infect Dis, 2016, 62(12): 1537-1545.
25.	Sweeney DA, Hicks CW, Cui X, et al. Anthrax Infection. Am J Respir Crit Care Med, 2011, 184(12): 1333-1341.
26.	Zhang J, Hou XY, Wang JY, et al. Case report: cutaneous anthrax diagnosed using mNGS of a formalin-fixed paraffin-embedded tissue sample. Front Cell Infect Microbiol, 2024, 14: 1329235.
27.	Liu Y, Zheng G, Li J, et al. A case report of cutaneous anthrax diagnosed by using a metagenomic next-generation sequencing (mNGS) approach. Infect Drug Resist, 2023, 16: 3601-3606.
28.	Zasada AA. Detection and identification of Bacillus anthracis: from conventional to molecular microbiology methods. Microorganisms, 2020, 8(1): 125.
29.	Ziółkowski R, Oszwałdowski S, Zacharczuk K, et al. Electrochemical detection of Bacillus anthracis protective antigen gene using DNA biosensor based on stem-loop probe. J Electrochem Soc, 2018, 165(5): B187-B195.
30.	Zhang B, Dallo S, Peterson R, et al. Detection of anthrax lef with DNA-based photonic crystal sensors. J Biomed Opt, 2011, 16(12): 127006.
31.	中华人民共和国国家卫生健康委员会. 炭疽诊疗方案(2023年版). 中华人民共和国国家卫生健康委员会, 2023.
32.	Vodopivec I, Rinehart EM, Griffin GK, et al. A cluster of cns infections due to B. cereus in the setting of acute myeloid leukemia: neuropathology in 5 patients. J Neuropathol Exp Neurol, 2015, 74(10): 1000-1011.
33.	Marston CK, Gee JE, Popovic T, et al. Molecular approaches to identify and differentiate Bacillus anthracis from phenotypically similar Bacillus species isolates. BMC Microbiol, 2006, 6: 22.
34.	Bower WA, Yu Y, Person MK, et al. CDC guidelines for the prevention and treatment of anthrax, 2023. MMWR Recomm Rep, 2023, 72(6): 1-47.
35.	Bradley JS, Bulitta JB, Cook R, et al. Central nervous system antimicrobial exposure and proposed dosing for anthrax meningitis. Clin Infect Dis, 2024, 78(6): 1451-1457.
36.	Ben-Shmuel A, Glinert I, Sittner A, et al. Doxycycline, levofloxacin, and moxifloxacin are superior to ciprofloxacin in treating anthrax meningitis in rabbits and NHP. Antimicrob Agents Chemother, 2024: e0161023.
37.	Sittner A, Ben-Shmuel A, Glinert I, et al. Using old antibiotics to treat ancient bacterium-β-lactams for Bacillus anthracis meningitis. PloS One, 2020, 15(2): e0228917.
38.	何达, 周凌云. 《炭疽诊疗方案(2023 年版)》解读. 中国抗生素杂志, 2024, 49(7): 749-754.
39.	Sejvar JJ, Tenover FC, Stephens DS. Management of anthrax meningitis. Lancet Infect Dis, 2005, 5(5): 287-295.
40.	Person MK, Cook R, Bradley JS, et al. Systematic review of hospital treatment outcomes for naturally acquired and bioterrorism-related anthrax, 1880-2018. Clin Infect Dis, 2022, 75(Suppl 3): S392-S401.

1. Bower WA, Hendricks KA, Vieira AR, et al. What is anthrax?. Pathogens, 2022, 11(6): 690.
2. Albayrak F, Memikoglu O, Kurt O, et al. A case of anthrax meningitis. Scand J Infect Dis, 2002, 34(8): 627-628.
3. Popescu CP, Zaharia M, Nica M, et al. Anthrax meningoencephalitis complicated with brain abscess - a case report. Int J Infect Dis, 2021, 108: 217-219.
4. Alam ME, Kamal MM, Rahman M, et al. Review of anthrax: a disease of farm animals. J Adv Vet Anim Res, 2022, 9(2): 323-334.
5. 张海霞. 人兽共患病-炭疽的综合防控. 山东畜牧兽医, 2022, 43(1): 66-69.
6. Wales A, Mackintosh A. JMM profile: Bacillus anthracis. J Med Microbiol, 2023, 72(8): 1-6.
7. Koehler TM. Bacillus anthracis physiology and genetics. Mol Aspects Med, 2009, 30(6): 386-396.
8. Head BM, Rubinstein E, Meyers AF. Alternative pre-approved and novel therapies for the treatment of anthrax. BMC Infect Dis, 2016, 16(1): 621.
9. Parlak E, Parlak M, Atli SB. Unusual cause of fatal anthrax meningitis. Cutan Ocul Toxicol, 2015, 34(1): 77-79.
10. Hendricks K, Person MK, Bradley JS, et al. Clinical features of patients hospitalized for all routes of anthrax, 1880-2018: a systematic review. Clin Infect Dis, 2022, 75(Suppl 3): S341-S353.
11. Kwong KL, Que TL, Wong SN, et al. Fatal meningoencephalitis due to Bacillus anthracis. J Paediatr Child Health, 1997, 33(6): 539-541.
12. Moayeri M, Leppla SH, Vrentas C, et al. Anthrax pathogenesis. Annu Rev Microbiol, 2015, 69: 185-208.
13. Ebrahimi CM, Sheen TR, Renken CW, et al. Contribution of lethal toxin and edema toxin to the pathogenesis of anthrax meningitis. Infect Immun, 2011, 79(7): 2510-2518.
14. Al-Obaidi MMJ, Desa MNM. Mechanisms of blood brain barrier disruption by different types of bacteria, and bacterial-host interactions facilitate the bacterial pathogen invading the brain. Cell Mol Neurobiol, 2018, 38(7): 1349-1368.
15. Ramarao N, Lereclus D. The InhA1 metalloprotease allows spores of the B. cereus group to escape macrophages. Cell Microbiol, 2005, 7(9): 1357-1364.
16. Mukherjee DV, Tonry JH, Kim KS, et al. Bacillus anthracis protease InhA increases blood-brain barrier permeability and contributes to cerebral hemorrhages. PloS One, 2011, 6(3): e17921.
17. van Sorge NM, Ebrahimi CM, McGillivray SM, et al. Anthrax toxins inhibit neutrophil signaling pathways in brain endothelium and contribute to the pathogenesis of meningitis. PloS One, 2008, 3(8): e2964.
18. Swartz MN. Recognition and management of anthrax — an update. N Engl J Med, 2001, 345(22): 1621-1626.
19. Yorgancigil B, Demirci M, Unlu M, et al. Anthrax meningitis: case report. Int J Infect Dis, 2001, 5(4): 220-221.
20. Tasyaran MA, Deniz O, Ertek M, et al. Anthrax meningitis: case report and review. Scand J Infect Dis, 2002, 34(1): 66-67.
21. Kim HJ, Jun WB, Lee SH, et al. CT and MR findings of anthrax meningoencephalitis: report of two cases and review of the literature. AJNR Am J Neuroradiol, 2001, 22(7): 1303-1305.
22. Caffes N, Hendricks K, Bradley JS, et al. Anthrax meningoencephalitis and intracranial hemorrhage. Clin Infect Dis, 2022, 75(Suppl 3): S451-S458.
23. Doganay M, Dinc G, Kutmanova A, et al. Human anthrax: update of the diagnosis and treatment. Diagnostics (Basel), 2023, 13(6): 1056.
24. Katharios-Lanwermeyer S, Holty JE, Person M, et al. Identifying meningitis during an anthrax mass casualty incident: systematic review of systemic anthrax since 1880. Clin Infect Dis, 2016, 62(12): 1537-1545.
25. Sweeney DA, Hicks CW, Cui X, et al. Anthrax Infection. Am J Respir Crit Care Med, 2011, 184(12): 1333-1341.
26. Zhang J, Hou XY, Wang JY, et al. Case report: cutaneous anthrax diagnosed using mNGS of a formalin-fixed paraffin-embedded tissue sample. Front Cell Infect Microbiol, 2024, 14: 1329235.
27. Liu Y, Zheng G, Li J, et al. A case report of cutaneous anthrax diagnosed by using a metagenomic next-generation sequencing (mNGS) approach. Infect Drug Resist, 2023, 16: 3601-3606.
28. Zasada AA. Detection and identification of Bacillus anthracis: from conventional to molecular microbiology methods. Microorganisms, 2020, 8(1): 125.
29. Ziółkowski R, Oszwałdowski S, Zacharczuk K, et al. Electrochemical detection of Bacillus anthracis protective antigen gene using DNA biosensor based on stem-loop probe. J Electrochem Soc, 2018, 165(5): B187-B195.
30. Zhang B, Dallo S, Peterson R, et al. Detection of anthrax lef with DNA-based photonic crystal sensors. J Biomed Opt, 2011, 16(12): 127006.
31. 中华人民共和国国家卫生健康委员会. 炭疽诊疗方案(2023年版). 中华人民共和国国家卫生健康委员会, 2023.
32. Vodopivec I, Rinehart EM, Griffin GK, et al. A cluster of cns infections due to B. cereus in the setting of acute myeloid leukemia: neuropathology in 5 patients. J Neuropathol Exp Neurol, 2015, 74(10): 1000-1011.
33. Marston CK, Gee JE, Popovic T, et al. Molecular approaches to identify and differentiate Bacillus anthracis from phenotypically similar Bacillus species isolates. BMC Microbiol, 2006, 6: 22.
34. Bower WA, Yu Y, Person MK, et al. CDC guidelines for the prevention and treatment of anthrax, 2023. MMWR Recomm Rep, 2023, 72(6): 1-47.
35. Bradley JS, Bulitta JB, Cook R, et al. Central nervous system antimicrobial exposure and proposed dosing for anthrax meningitis. Clin Infect Dis, 2024, 78(6): 1451-1457.
36. Ben-Shmuel A, Glinert I, Sittner A, et al. Doxycycline, levofloxacin, and moxifloxacin are superior to ciprofloxacin in treating anthrax meningitis in rabbits and NHP. Antimicrob Agents Chemother, 2024: e0161023.
37. Sittner A, Ben-Shmuel A, Glinert I, et al. Using old antibiotics to treat ancient bacterium-β-lactams for Bacillus anthracis meningitis. PloS One, 2020, 15(2): e0228917.
38. 何达, 周凌云. 《炭疽诊疗方案(2023 年版)》解读. 中国抗生素杂志, 2024, 49(7): 749-754.
39. Sejvar JJ, Tenover FC, Stephens DS. Management of anthrax meningitis. Lancet Infect Dis, 2005, 5(5): 287-295.
40. Person MK, Cook R, Bradley JS, et al. Systematic review of hospital treatment outcomes for naturally acquired and bioterrorism-related anthrax, 1880-2018. Clin Infect Dis, 2022, 75(Suppl 3): S392-S401.

West China Medical Journal

Progress of research on anthrax meningitis

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