Harris L F, Striplin W H, Burnside R C
School of Primary Medical Care, University of Alabama School of Medicine, Huntsville 35801.
Ala Med. 1991 Oct;61(4):8, 10.
We describe two patients with Mycobacterium marinum infection and review the pertinent literature. M. marinum infection follows trauma, often trivial, in water or from marine life. Clinical manifestations include superficial cutaneous lesions which are either solitary or multiple in a sporotrichoid distribution, involvement of the deeper structures of the hand and wrist and disseminated disease. Biopsy of infected tissue reveals a mixed suppurative-granulomatous reaction with sparse to absent acid-fast bacilli. Definitive diagnosis is achieved by growing the organism from appropriate specimens. Suggested therapeutic regimens consist of rifampin and ethambutol for advanced disease and infection invading the deeper structures of the hand and wrist and one of the tetracyclines or trimethoprim-sulfamethoxazole for early or minimal disease. Surgical debridement is advised when there is persistent pain, a discharging sinus or previous local injection of corticosteroids.
我们描述了两名海分枝杆菌感染患者，并回顾了相关文献。海分枝杆菌感染通常在接触水或海洋生物后因轻微创伤而发生。临床表现包括浅表皮肤病变，可为孤立性或呈孢子丝菌病样分布的多发性病变，手部和腕部深部结构受累以及播散性疾病。感染组织活检显示为混合性化脓性 - 肉芽肿反应，抗酸杆菌稀少或无。通过从适当标本中培养出该病原体可实现明确诊断。对于晚期疾病以及感染侵犯手部和腕部深部结构的情况，建议的治疗方案包括利福平和乙胺丁醇；对于早期或轻微疾病，可使用四环素类药物或甲氧苄啶 - 磺胺甲恶唑中的一种。当存在持续疼痛、有排脓窦道或先前局部注射过皮质类固醇时，建议进行手术清创。
