American Board of Internal Medicine (ABIM) Certification Practice Exam

What defines uncomplicated cutaneous anthrax?

1. Presence of systemic symptoms

2. Significant swelling and inflammation

3. Absence of systemic symptoms

4. Localized swelling and redness

The correct answer is: Absence of systemic symptoms

Uncomplicated cutaneous anthrax is characterized by the absence of systemic symptoms, which distinguishes it from more severe forms of anthrax. In uncomplicated cases, the infection remains localized to the skin, starting primarily with a characteristic small papule that eventually develops into a painless ulcer with a characteristic black necrotic eschar. The lack of systemic symptoms, such as fever, chills, or malaise, indicates that the patient is not experiencing a generalized infectious response, which can often be associated with complications or more severe disease presentations. This localized nature often allows for a good prognosis and effective treatment with antibiotics, prioritizing symptom relief while monitoring for any potential complications. Although significant swelling and inflammation can occur in some cases, they are not defining characteristics of uncomplicated cutaneous anthrax specifically. Instead, localized swelling and redness may accompany the condition but should not be confused with the broader systemic involvement seen in complicated cases. Therefore, the defining factor for uncomplicated cutaneous anthrax remains the absence of systemic symptoms.