Death usually occurs within 24 hours and may be accompanied by septic shock. Autopsy usually reveals hemorrhagic necrosis of the thoracic lymph nodes, drainage from the lungs, and hemorrhagic mediastinitis. Gastrointestinal Infection Gastrointestinal infection has not been reported in the United States. It occurs primarily in developing countries, usually after ingestion of contaminated meat. The incubation period is usually three to five days.
Patients initially have nausea, vomiting, anorexia, and fever.
These symptoms are rapidly followed by acute abdominal pain, hematemesis, and bloody diarrhea. Findings on examination suggest an acute surgical abdomen, and there is moderate leukocytosis with immature band forms. Rapid progression to toxemia and shock leads to death within two to five days after the initial onset of symptoms. An oropharyngeal form of anthrax has also been described. Inflammatory lesions that resemble the cutaneous lesions develop on the posterior pharynx, hard palate, or tonsils.