皮肤炭疽22例临床分析

Clinical Analysis of 22 Cases of Cutaneous Anthrax

目的探讨皮肤炭疽患者的临床特征及诊治方法。方法对22例皮肤炭疽病例的临床表现及诊治进行回顾性分析。结果22例皮肤炭疽患者中,年龄7~56岁,男∶女为1.44∶1,中青年为主。患者均有牲畜接触病史,皮损表现以水疱为主,皮肤组织高度水肿合并局部组织坏死。发病部位以右上肢为主,其次为面部和左上肢,皮损发生于腕部以上的患者全身症状严重。病变组织分泌物直接涂片镜检示棒状革兰氏阳性杆菌。治疗采用静脉点滴青霉素联合左氧氟沙星及氢化可的松、硫酸镁溶液局部湿敷,治疗2~4周痊愈。结论本地区的皮肤炭疽患者根据流行病学接触史、典型临床表现和病原学检查可明确诊断,青霉素仍为首选治疗。

Objective To explore the clinical features and diagnosis of cutaneous anthrax.Methods The clinical manifestations and diagnosis of 22 cases cutaneous anthrax were analyzed retrospectively.Results Twenty-two cases of skin anthrax,aged 7~56 years,male∶female 1.44∶1,mainly young and middle-aged.All the patients had a history of contact with livestock.The skin lesions were mainly vesicles.The skin tissue was highly edematous with local necrosis.The predilection site was the right upper limb,then the face and left upper limb.The patients with skin lesions above the wrist had serious systemic symptoms.Direct smear of the secretion of the lesional tissue showed Gram-positive rod-shaped bacteria.Intravenous penicillin combined with levofloxacin and hydrocortisone were administrated in the treatment,and magnesium sulfate solution were used for local wet compression,all patients were cured in 2~4 weeks.Conclusion Based on the epidemiological contact history,typical clinical manifestations,combined with etiological examination,the diagnosis can be made definitely.Penicillin is the first choice for treatment.