<prompt> In inhalational anthrax, finding is:Consolidation and pleural effusionMediastinal widening and pleural effusionBilateral patchy opacities with pleural effusionNone of the above  <response>: Ans: b mediastinal widening and pleural effusion Ref: Davidson 20th edp.333.This is a direct pick from Davidson.Three forms of infection with Bacillus anthracis:-i Cutaneous anthrax Skin lesion due to occupational exposure to anthrax spores or bioterrorism. Spores inoculated into exposed skin single lesion, an irritated papule on oedematous haemorrhagic base depressed black eschar. Pain infrequent.ii Gastrointestinal anthrax Ingestion of contaminated meat products Caecum is the seat of infection CF - nausea, vomiting, anorexia, fever. Later severe abdominal pain and bloody diarrhoea. Toxaemia and death thereafter.iii Inhalational anthrax Rare. Associated with bioterrori sm. Great mortality CF - fever, dyspnoea, cough, headache. Later on septicaemia. CXR- mediastinal widening and pleural effusion.Investigation: Culture from Skin swabs.Management:Ciprofloxacin 500mg daily until penicillin susceptibility confirmed.Benzylpenicillin 600 000units i.m. 6 hourly.Aggressive fluid resuscitation. Ventilatory assistance in inhalational anthrax.Prophylaxis:Ciprofloxacin 500mg 12hourly for high risk from exposure. 