Jernigan J A, Farr B M
Emory University School of Medicine, Atlanta, GA, USA.
Clin Infect Dis. 2000 Aug;31(2):439-43. doi: 10.1086/313972. Epub 2000 Aug 30.
The diagnosis of cutaneous Mycobacterium marinum infection is often delayed for months after presentation, perhaps because important clinical clues in the patient's history are frequently overlooked. Knowledge of the incubation period allows the clinician to target questions about the patient's history. Prompted by a case with a prolonged incubation period, we sought to determine more precisely the incubation period of M. marinum infection. The MEDLINE database for the period 1966-1996 was searched for information regarding incubation period and type of exposure preceding M. marinum infection. Ninety-nine articles were identified, describing 652 cases. Forty cases had known incubation periods (median, 21 days; range, 5-270 days). Thirty-five percent of cases had an incubation period > or =30 days. Of 193 infections with known exposures, 49% were aquarium-related, 27.4% were related to fish or shellfish injuries, and 8.8% were related to injuries associated with saltwater or brackish water. Because the incubation period for cutaneous M. marinum infection can be prolonged, patients with atypical cutaneous infections should be questioned about high-risk exposures that may have occurred up to 9 months before the onset of symptoms.
皮肤海分枝杆菌感染的诊断通常在出现症状数月后才得以确立，这可能是因为患者病史中的重要临床线索常常被忽视。了解潜伏期有助于临床医生针对患者病史进行提问。受一例潜伏期延长病例的启发，我们试图更精确地确定海分枝杆菌感染的潜伏期。检索了1966年至1996年期间的MEDLINE数据库，以获取有关海分枝杆菌感染前潜伏期及暴露类型的信息。共识别出99篇文章，描述了652例病例。其中40例有已知的潜伏期（中位数为21天；范围为5至270天）。35%的病例潜伏期≥30天。在193例已知暴露情况的感染病例中，49%与水族箱相关，27.4%与鱼或贝类损伤有关，8.8%与海水或微咸水相关的损伤有关。由于皮肤海分枝杆菌感染的潜伏期可能延长，对于非典型皮肤感染患者，应询问其在症状出现前长达9个月内可能发生的高危暴露情况。
