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皮肤和软组织感染。

Skin and Soft Tissue Infections.

机构信息

Department of Medicine, University of Arizona Health Sciences Center, Tucson, AZ 85721.

Division of Infectious Diseases, University of Arizona, Tucson, AZ 85721.

出版信息

Microbiol Spectr. 2016 Aug;4(4). doi: 10.1128/microbiolspec.DMIH2-0014-2015.

Abstract

The skin is colonized by a diverse collection of microorganisms which, for the most part, peacefully coexist with their hosts. Skin and soft tissue infections (SSTIs) encompass a variety of conditions; in immunocompromised hosts, SSTIs can be caused by diverse microorganisms-most commonly bacteria, but also fungi, viruses, mycobacteria, and protozoa. The diagnosis of SSTIs is difficult because they may commonly masquerade as other clinical syndromes or can be a manifestation of systemic disease. In immunocompromised hosts, SSTI poses a major diagnostic challenge, and clinical dermatological assessment should be initially performed; to better identify the pathogen and to lead to appropriate treatment, etiology should include cultures of lesions and blood, biopsy with histology, specific microbiological analysis with special stains, molecular techniques, and antigen-detection methodologies. Here, we reviewed the epidemiology, pathophysiology, clinical presentation, and diagnostic techniques, including molecular biological techniques, used for SSTIs, with a focus on the immunocompromised host, such as patients with cellular immunodeficiency, HIV, and diabetic foot infection.

摘要

皮肤被多种微生物定植,这些微生物在大多数情况下与宿主和平共处。皮肤和软组织感染(SSTIs)包括多种疾病;在免疫功能低下的宿主中,SSTIs 可由多种微生物引起——最常见的是细菌,但也有真菌、病毒、分枝杆菌和原生动物。SSTIs 的诊断较为困难,因为它们可能通常伪装成其他临床综合征,也可能是全身性疾病的表现。在免疫功能低下的宿主中,SSTI 构成了重大的诊断挑战,应首先进行临床皮肤科评估;为了更好地识别病原体并进行适当的治疗,病因学应包括病变和血液培养、组织学活检、特殊染色的特定微生物分析、分子技术和抗原检测方法。在这里,我们回顾了 SSTIs 的流行病学、病理生理学、临床表现和诊断技术,包括分子生物学技术,并重点关注免疫功能低下的宿主,如细胞免疫缺陷、HIV 和糖尿病足感染患者。

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