Injectional anthrax in a heroin skin-popper

Anthrax is rare in western Europe but may arise sporadically in people expo sed to animal products from endemic areas. A heroin-injecting drug; user pr esented with a severe soft-tissue infection at the injection sits, septic s hock, and meningitis. A gram-positive endospore-forming aerobic rod was iso lated from the soft tissue and cerebrospinal fluid; confirmation of Bacillu s anthracis was made by PCR. Since contaminated heroin was the probable sou rce of infection, this case is of concern and warrants surveillance.