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法国三例相关皮肤炭疽病例:临床与实验室情况

Three related cases of cutaneous anthrax in France: clinical and laboratory aspects.

作者信息

Cinquetti Gaël, Banal Frédéric, Dupuy Anne-Laure, Girault Pierre-Yves, Couderc Anne, Guyot Pauline, Alauzet Corentine, Oddoux Olivier, Ragot Céline, Puyhardy Jean-Michel, Graffin Bruno, Veran Yolande

机构信息

From Service de Dermatologie (GC, ALD, PYG, AC, PG, YV), Service de Medecine Interne et Maladies Infectieuses et Tropicales (FB, BG), Service de Biologie (OO, CR, JMP), Hôpital d'Instruction des Armées Legouest, Metz; and Laboratoire de Bactériologie (CA), Centre Hospitalier et Universitaire de Nancy, Nancy, France.

出版信息

Medicine (Baltimore). 2009 Nov;88(6):371-375. doi: 10.1097/MD.0b013e3181c202fa.

Abstract

Anthrax is an acute bacterial infection caused by Bacillus anthracis. The infection is cutaneous in about 95% of human cases and respiratory in about 5%. Approximately 2000 cases of cutaneous anthrax are reported annually worldwide. This disease became exceptional in Europe thanks to strict veterinarian monitoring. The last human cases of anthrax indicated in France were in 1997. We report 3 new related cases of naturally acquired cutaneous anthrax that occurred in France in 2008. The unique features of these cases include the atypical clinical presentation and the contribution of the rapid and specific diagnosis techniques by polymerase chain reaction.In cutaneous forms of anthrax, although the local course is not influenced by the treatment, antibiotic therapy is necessary to control any bacterial distribution. A case of exposure similar to that of a confirmed human case or an exposure identified by epidemiologic inquiry should usually result in chemoprophylaxis. Chemoprophylaxis for the close relations of a patient or for health workers is unnecessary since person-to-person transmission has not been reported.

摘要

炭疽是由炭疽杆菌引起的一种急性细菌感染。在人类病例中,约95%的感染为皮肤型,约5%为呼吸道型。全球每年报告约2000例皮肤炭疽病例。由于严格的兽医监测,这种疾病在欧洲已属罕见。法国上一次报告的人类炭疽病例是在1997年。我们报告了2008年在法国发生的3例新的自然获得性皮肤炭疽相关病例。这些病例的独特之处包括非典型的临床表现以及聚合酶链反应快速特异性诊断技术的应用。在皮肤型炭疽中,尽管局部病程不受治疗影响,但抗生素治疗对于控制任何细菌传播是必要的。与确诊人类病例相似的暴露情况或通过流行病学调查确定的暴露情况通常应进行化学预防。由于尚未报告人传人情况,因此对患者的密切接触者或医护人员进行化学预防并无必要。

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