Hess Christopher L, Wolock Bruce S, Murphy Michael S
Division of Plastic Surgery, Medstar-Georgetown University Hospital, Washington, DC 20007, USA.
Plast Reconstr Surg. 2005 Mar;115(3):55e-59e. doi: 10.1097/01.prs.0000153197.64808.b9.
A significant number of patients infected with Mycobacterium marinum have been treated at the Curtis National Hand Center in Baltimore, Maryland. The purpose of this study was to review the authors' experience with M. marinum infections of the upper extremity. Twenty-nine patients were identified and their charts were reviewed for all factors related to diagnosis and treatment. The most common presenting symptoms were swelling (n = 25) and pain (n = 14). Only 69 percent of patients could correlate their injury with aquatic activities. The mean time from injury to diagnosis was 5.2 months. Acid-fast bacilli stains were positive in only 22 percent of specimens. The mean number of procedures was 1.75, with the majority being tenosynovectomy. The mean duration of antibiotic therapy was 6 months. Clinical history, pathological evaluation, and a high clinical suspicion can lead to early diagnosis and introduction of antibiotics. The authors' patients were successfully treated with 6 months of antibiotic therapy and early surgical intervention.
大量感染海分枝杆菌的患者在马里兰州巴尔的摩的柯蒂斯国家手部中心接受了治疗。本研究的目的是回顾作者在上肢海分枝杆菌感染方面的经验。确定了29例患者，并对其病历进行了与诊断和治疗相关的所有因素的回顾。最常见的症状是肿胀（n = 25）和疼痛（n = 14）。只有69%的患者能够将其损伤与水上活动联系起来。从受伤到诊断的平均时间为5.2个月。仅22%的标本抗酸杆菌染色呈阳性。手术的平均次数为1.75次，大多数是腱鞘切除术。抗生素治疗的平均持续时间为6个月。临床病史、病理评估和高度的临床怀疑可导致早期诊断和使用抗生素。作者的患者通过6个月的抗生素治疗和早期手术干预获得了成功治疗。
