Radun D, Bernard H, Altmann M, Schöneberg I, Bochat V, van Treeck U, Rippe R, Grunow R, Elschner M, Biederbick W, Krause G (2010): Preliminary case report of fatal anthrax in an injecting drug user in North-Rhine-Westphalia, Germany, December 2009
Euro Surveill. 15 (2): pii=19464.

A fatal case of anthrax is described in a 42-year-old male injecting drug user in Germany in December 2009. The patient was hospitalized on 6 December 2009, complaining of a swelling of his leg following drug injection into the popliteal fossa. Following treatment with meropenem and surgical debridement of a subsequent necrotizing fasciitis, the patient died with multiorgan failure on 13 December 2009. Anthrax had not been suspected clinically. Spore-forming bacteria from a wound swab specimen were identified, and on 18 December, the diagnosis of anthrax was confirmed by polymerase chain reaction.