Streit M, Bregenzer T, Heinzer I
Dermatologische Abteilung, Kantonsspital Aarau, Tellstrasse, 5001 Aarau, Schweiz.
Hautarzt. 2008 Jan;59(1):59-70; quiz 71. doi: 10.1007/s00105-007-1447-1.
Atypical mycobacteria are environmental saprophytes. Occasionally they may enter human skin through injuries and cause localized infection. Papules, nodules, plaques, ulcers and panniculitis-like lesions are common manifestations. Disseminated infection occurs in immunocompromised patients. Evidence of mycobacterial infection can be obtained by tissue specimens, culture being most important for diagnosis. Because many mycobacteria only grow on special media and at special temperatures it is crucial that clinical suspicion is raised so correct testing is performed. Buruli ulcer caused by M. ulcerans is the most prevalent atypical mycobacteriosis worldwide; its occurrence is restricted to tropical areas. In European countries fish tank granuloma caused by M. marinum is most commonly observed. M. avium-complex, M. kansasii und rapidly growing mycobacteria of M. fortuitum-complex are other atypical mycobacteria that can cause cutaneous infection. Treatment is difficult because many atypical mycobacteria are resistant to common antibiotics.
非结核分枝杆菌是环境腐生菌。它们偶尔可通过伤口进入人体皮肤并引起局部感染。丘疹、结节、斑块、溃疡和脂膜炎样病变是常见表现。播散性感染发生在免疫功能低下的患者中。通过组织标本可获得分枝杆菌感染的证据，培养对于诊断最为重要。由于许多分枝杆菌仅在特殊培养基和特殊温度下生长，因此提高临床怀疑并进行正确检测至关重要。由溃疡分枝杆菌引起的布鲁里溃疡是全球最常见的非结核分枝杆菌病；其发生仅限于热带地区。在欧洲国家，最常观察到由海分枝杆菌引起的鱼缸肉芽肿。鸟分枝杆菌复合体、堪萨斯分枝杆菌和偶然分枝杆菌复合体的快速生长分枝杆菌是其他可引起皮肤感染的非结核分枝杆菌。治疗困难，因为许多非结核分枝杆菌对常用抗生素耐药。
