All children exposed to B anthracis spores should receive at least 60 days of antimicrobial prophylaxis with the most effective agents, even if these agents are associated with increased side effects compared with antimicrobials more often used in children.
Patients with systemic anthrax initially might not appear critically ill. Because of the potential for sudden decline, hospitalized patients should have careful hemodynamic monitoring. Chest CT might be needed to identify the characteristic widened mediastinum and pleural effusions associated with inhalation anthrax