Tekin Recep, Sula Bilal, Devecı Ozcan, Tekin Alicem, Bozkurt Fatma, Ucmak Derya, Kaya Şafak, Bekcibasi Muhammed, Erkan Mehmet Emin, Ayaz Celal, Hosoglu Salih
Department of Infectious Diseases and Clinical Microbiology .
Cutan Ocul Toxicol. 2015 Mar;34(1):7-11. doi: 10.3109/15569527.2014.880844. Epub 2014 Mar 31.
Anthrax is a rare disease cause by Bacillus anthracis, a Gram-positive, rod-shaped endospore-forming capsuled bacterium. Anthrax is manifest in three primary forms: cutaneous, respiratory, and gastrointestinal. Cutaneous anthrax accounts for approximately 95% of all cases of anthrax in humans.
In the present study, we evaluated the clinical diagnosis and treatment of cutaneous anthrax, a rare disease that nonetheless remains a serious healthcare problem in developing countries.
The complete medical records of patients diagnosed with cutaneous anthrax between January 2001 and December 2012 were examined in a retrospective manner. Cutaneous anthrax was diagnosed by the identification of typical anthrax lesions and/or the presence of Gram-positive-capsuled bacillus after staining with Gram stain and methylen blue in pathology samples obtained from these lesions and the presence of characteristic scarring with a history of severe swelling, black eschar, and positive response to treatment form the basis of diagnosis in cases where cultures were negative for the presence of bacillus.
A total of 58 patients were admitted to the hospital with cutaneous anthrax between January 2001 and December 2012. This included 32 (55.2%) males and 26 (44.8%) females, with an age range of 15-82 years and a mean age of 38 ± 13.8 years. The incubation period for the infection ranged between 1 and 20 d (mean 3.7 ± 1.4 d). The most common symptoms at the time of hospital referral were swelling, redness, and black eschar of the skin. The most common lesion site was the hand and fingers (41.3%). Isolated of bacteria was used to diagnose the disease in six cases (23.8%), detection of Gram-positive bacillus in samples of characteristic lesion material was used in seven (28.5%) cases, and the presence of a characteristic lesion was the sole diagnostic criteria in 45 (77.6%) cases. Treatment consisted of penicillin G (12 cases), ampicillin-sulbactam (30 cases), Cefazolin (12 cases), or ciprofloxacin (4 cases).
Although the prevalence of anthrax is a decreasing worldwide, it remains a significant problem in developing countries. Rapid identification of the signs and symptoms of cutaneous anthrax is essential for effective treatment. Early supportive treatment and appropriate antimicrobial measures are necessary to address this potentially life-threatening disease.
炭疽是由炭疽芽孢杆菌引起的一种罕见疾病，炭疽芽孢杆菌是一种革兰氏阳性、杆状、形成芽孢的有荚膜细菌。炭疽主要有三种表现形式：皮肤型、呼吸道型和胃肠道型。皮肤型炭疽约占人类炭疽病例的95%。
在本研究中，我们评估了皮肤型炭疽的临床诊断和治疗，这种罕见疾病在发展中国家仍然是一个严重的医疗问题。
以回顾性方式检查了2001年1月至2012年12月期间诊断为皮肤型炭疽的患者的完整病历。通过在从这些病变获取的病理样本中经革兰氏染色和亚甲蓝染色后鉴定典型的炭疽病变和/或存在革兰氏阳性有荚膜杆菌来诊断皮肤型炭疽，在培养未发现杆菌的病例中，有严重肿胀、黑色焦痂的特征性瘢痕形成以及对治疗的阳性反应构成诊断依据。
2001年1月至2012年12月期间，共有58例皮肤型炭疽患者入院。其中男性32例（55.2%）,女性26例（44.8%），年龄范围为15 - 82岁，平均年龄为38±13.8岁。感染的潜伏期为1至20天（平均3.7±1.4天）。入院时最常见的症状是皮肤肿胀、发红和黑色焦痂。最常见的病变部位是手和手指（41.3%）。6例（23.8%）通过细菌分离来诊断疾病，7例（28.5%）通过在特征性病变材料样本中检测革兰氏阳性杆菌来诊断，45例（77.6%）以存在特征性病变作为唯一诊断标准。治疗包括青霉素G（12例）、氨苄西林 - 舒巴坦（30例）、头孢唑林（12例）或环丙沙星（4例）。
虽然炭疽在全球的发病率正在下降，但在发展中国家它仍然是一个重大问题。快速识别皮肤型炭疽的体征和症状对于有效治疗至关重要。早期支持性治疗和适当的抗菌措施对于应对这种潜在的危及生命的疾病是必要的。
