{"ops":[{"insert":"A 48 year old cattle farmer presents with multiple painless black lesions on his right arm.\n\nTwo weeks ago he had accidentally grazed his right arm on a farm tool.\n\nA few days later, pruritic papules appeared at that sites. These subsequently progressed into larger lesions surrounded by edema, over the following weeks.\n\nHis medical, surgical and drug histories are unremarkable. He does not smoke or consume alcohol, and denies abuse of prescription drugs.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-144_en.png"}},{"insert":"\n"}]}
2
Investigate
Skin Lesion Culture + Gram Stain
{"ops":[{"insert":"The gram stain reveals large, square-ended, gram-positive rods growing in chains, containing oval, central to subterminal spores.\nAfter 24h, cultures reveal dull, flat, white-grey non-hemolytic colonies, consistent with Bacillus anthracis.\n"}]}
Nasopharyngeal Cultures
{"ops":[{"insert":"Gram stain: Normal upper respiratory flora\nCulture results will be available in 3 days.\n"}]}
