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作 者:储旭东[1] 林钢[1] 尹洪波[1] 崔业江[1] 李健[1] 屠聿修[2] 殷凯生[2] 童明庆[2] 刘再鹏[3] 薛建辉[3]
机构地区:[1]东台市人民医院,224200 [2]南京医科大学附属第一医院 [3]江苏省中医院
出 处:《江苏医药》2004年第6期412-414,共3页Jiangsu Medical Journal
摘 要:目的 探讨皮肤软组织肌注后龟分支杆菌皮肤感染的临床特点、诊断和治疗手段。方法 分析 2 0 0 0年 12月~ 2 0 0 1年 3月 6 3例非结核性分支杆菌皮肤感染患者的临床表现、病理、B超、药物敏感试验、治疗结果。结果 6 3例患者的 99处感染灶可分为混合溃疡型 5 1例次 ,脓肿型 2 8例次 ,硬结型 16例次 ,蜂窝织炎型 4例次。病理显示为肉芽肿、类结核结节占多数。其中 38例经细菌培养证实为龟分支杆菌感染。全部病例经敏感抗菌药和抗结核药联合应用及外科治疗后 6~ 8个月痊愈。结论 皮肤软组织龟分支杆菌感染暴发流行很罕见 ,临床表现多样化 ,易反复 ,病程长 ,对多种抗菌药物耐药 ,治疗困难。Objective To study the clinical characteristics,diagnosis and treatment of Mycobacterium chelonae infection of skin soft tissues after intramuscular injection.Methods We collected 63 cases of and analyzed their clinical features,photographic,B-mode ultrasonic,drug sensitive test,and therapeutic results infection.Results The patients,ages ranged from 8 month to 77yrs,with an average of 33.4.25.4percent(16) were men.The incubation period ranged from 7 to 162 days,with an average of 39.2±29 days.The 63 cases of infections were divided into 4 types:51 cases of mixed ulceration,28 cases of abscess,16 cases of sclerosis,4 cases of phlegmones type.The pathological observation showed mostly granuloma and tuberculoid.Bacteria culture revealed 38 cases of them were validated infections by Mycobacterium chelonae.All cases were cured by combining sensitive antibacterial,antitubercular drugs and surgical therapy in 6~8 months.Conclusion Outbreaks of iatrogenic infections of skin and soft tissue by Mycobacterium chelonae are rare,and have a variety of clinical manifestations:recurrence,long disease course,resistance to antibacterials and difficulty to treat.
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