Pathology of inhalational anthrax in 42 cases from the Sverdlovsk outbreak of 1979

Faina A. Abramova, Lev M. Grinberg, Olga V. Yampolskaya, David H. Walker

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319 Scopus citations


A large epidemic of anthrax that occurred in Sverdlovsk (now Ekaterinburg), Russia, in 1979 resulted in the deaths of many persons. A series of 42 necropsies, representing a majority of the fatalities from this outbreak, consistently revealed pathologic lesions diagnostic of inhalational anthrax, namely hemorrhagic necrosis of the thoracic lymph nodes in the lymphatic drainage of the lungs and hemorrhagic mediastinitis. Bacillus anthracis was recovered in bacterial cultures of 20 cases, and organisms were detected microscopically in the infected tissues of nearly all of the cases. A novel observation was primary focal hemorrhagic necrotizing pneumonia at the apparent portal of entry in 11 cases. Mesenteric lymphadenitis occurred in only 9 cases. This remarkably large series demonstrated the full range of effects of anthrax bacteremia and toxemia (edema especially adjacent to sites of extensive infection and pleural effusions) and hematogenously disseminated infection [hemorrhagic meningitis (21 cases) and multiple gastrointestinal submucosal hemorrhagic lesions (39 cases)].

Original languageEnglish (US)
Pages (from-to)2291-2294
Number of pages4
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number6
StatePublished - Mar 15 1993


  • Bacillus anthracis
  • Epidemic
  • Hemorrhagic mediastinitis
  • Hemorrhagic thoracic lymphadenitis
  • Russia

ASJC Scopus subject areas

  • General


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