The history, including the occupation of the person, is important. The bacteria may be found in cultures or smears in cutaneous (skin) anthrax and in throat swabs and sputum in pulmonary anthrax. Chest X-rays may also show characteristic changes in and between the lungs. Once the anthrax is disseminated, bacteria can be seen in the blood using a microscope. Of course, if anthrax is deliberately spread, the manifestations of the disease may be unusual. Indeed, in the bioterrorism attack in the U.S. in 2001, anthrax spores were spread through the postal system as a white powder mailed with letters.