Familial cluster of cutaneous anthrax in North Khorasan, Iran: A case series and public health reflection.

BACKGROUND

Cutaneous anthrax remains a persistent zoonotic threat in endemic agricultural regions. Iran, particularly North Khorasan Province, continues to report sporadic cases, especially among individuals involved in livestock processing.

CASE PRESENTATIONS: We describe a familial cluster of three cases of cutaneous anthrax following exposure to contaminated sheep meat in a rural village. All patients presented with characteristic black eschars on the hands and received initial inappropriate antibiotic treatment with cephalexin. Microbiological confirmation of Bacillus anthracis was achieved through smear and swab cultures. Subsequent treatment with ciprofloxacin led to full recovery in each case.

CONCLUSION

These cases highlight the importance of accurate and timely diagnosis, the risks associated with the empirical use of ineffective antibiotics, and the need for clinician awareness in endemic settings. Public health responses should incorporate veterinary control measures, public education, and clinician training to prevent future cases.