外伤后细菌性致死性肉芽肿——一种新的疾病?

Fatal Bacteria Granuloma after Trauma-A New Disease?

近 2 0余年在我国多个地区发现一种外伤后皮肤肉芽肿。所发现的 2 0余例有以下特点 :①面、额部轻微外伤史 ;②皮肤进行性暗红色斑块 ,不溃破 ;③可在皮损附近或远处出现新的斑块 ;④病理示组织细胞肉芽肿 ;⑤后期出现意识障碍、剧烈头痛 ,但无明显的脑膜刺激征 ;⑥全部病人在 1.5～ 4年内死亡 ;⑦糖皮质激素可使皮损暂时好转 ,但显著加速死亡 ;⑧患者均来自农村。最近通过透射电镜等肯定了 1例皮损内存在至少两种细菌 ,结合以往发现的 3例予以报道。鉴于该病凶险 ,在反映疾病特征的命名中加上“致死性”以期得到重视。

Objective A kind of cutaneous granuloma after trauma was noticed in China in past 20 years.All these patients,more than 20 cases,showed following features:①a history of slight trauma at face;②growing dark-red plaque,never ruptured;③new plaques appearing near or far from original lesion;④histocytic granuloma on histopathology;⑤patients feeling serious headache and consciousness obstruction during the later stage of the disease,but no meningeal irritation was found;⑥all patients died within 1.5～4 years;⑦prednisone could lighten the lesion but accelerating die;⑧all patients coming from rural area.At least two types of bacteria were found in 1 case with transmit electron microscope.Four cases were reported in this article.Because of the severity of the disease,the authers give the term'fatal' so that it may have the reader's attention.