Gross Itai, Ben Nachum Noa, Molho-Pessach Vered, Weiser Giora, Oster Yonatan, Engelhard Dan, Megged Orli, Hashavya Saar
Department of Pediatric Emergency Medicine, Hadassah Medical Center, Jerusalem, Israel.
Department of Pediatric Emergency Medicine, Queensland Children's Hospital, Brisbane, Australia.
Pediatr Dermatol. 2020 May;37(3):476-479. doi: 10.1111/pde.14124. Epub 2020 Mar 1.
Molluscum contagiosum (MC) is a common skin infection in the pediatric age group. The infection is self-limited and manifests as discrete, umbilicated skin-colored papules on any skin surface of the body. At times, complications such as local dermatitis and swelling, erythema, and pus formation may appear. These signs of inflammation are commonly presumed to represent bacterial infection.
This multicenter study was a retrospective analysis of data collected on all patients diagnosed with inflamed lesions secondary to MC and treated at the Hadassah Medical Centers and Shaare Zedek Medical Center in Jerusalem, Israel, from 1/1/2008 to 1/07/2018. Characteristics of children with positive cultures were compared to those with negative cultures and those with contaminants.
A total of 56 cases were reviewed; the mean age at presentation was 4.6 years. Fever was reported in 12.5%, and 62.5% received systemic antibiotics because of their inflamed MC prior to admission. Fifty-five percent had sterile cultures or cultures growing only contaminants. Only seven had positive cultures with the common cutaneous pathogens. No statistical difference was observed between the patients with pathogenic isolates and patients with sterile or non-pathogenic cultures in terms of demographics, lesion characteristics, inflammatory markers, or length of hospitalization.
The findings suggest that most cases of suspected MC-related secondary infection can be attributed to inflammation rather than to bacterial infection. However, in some cases, true bacterial infection should be suspected and treated accordingly.
传染性软疣（MC）是儿童期常见的皮肤感染。这种感染具有自限性，表现为身体任何皮肤表面上离散的、脐凹状的肤色丘疹。有时，可能会出现局部皮炎、肿胀、红斑和脓液形成等并发症。这些炎症迹象通常被认为代表细菌感染。
这项多中心研究是对2008年1月1日至2018年7月1日期间在以色列耶路撒冷的哈达萨医疗中心和沙雷·泽德克医疗中心诊断为继发于MC的炎症性病变并接受治疗的所有患者收集的数据进行的回顾性分析。将培养结果为阳性的儿童的特征与培养结果为阴性的儿童以及培养出污染物的儿童的特征进行比较。
共审查了56例病例；就诊时的平均年龄为4.6岁。12.5%的患者报告有发热，62.5%的患者在入院前因炎症性MC接受了全身抗生素治疗。55%的患者培养结果为无菌或仅培养出污染物。只有7例培养出常见皮肤病原体的阳性结果。在人口统计学、病变特征、炎症标志物或住院时间方面，有病原菌分离株的患者与无菌或非病原菌培养结果的患者之间未观察到统计学差异。
研究结果表明，大多数疑似MC相关继发感染的病例可归因于炎症而非细菌感染。然而，在某些情况下，应怀疑并相应治疗真正的细菌感染。
