International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, Vall d'Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain.
Hospital Nossa Senhora da Paz, Cubal, Angola.
Int J Infect Dis. 2024 Mar;140:104-109. doi: 10.1016/j.ijid.2024.01.004. Epub 2024 Jan 7.
Bacillus anthracis infection is a worldwide zoonosis that affects the most vulnerable population and has a high mortality rate without treatment, especially in non-cutaneous presentations. Cutaneous scarification is still common in some regions of the world for the treatment of certain diseases as part of traditional medicine. We describe a series of cutaneus anthrax from a rural setting in Angola where cutaneus scarification is common.
This is a retrospective observational study describing a series of cutaneous anthrax cases from Cubal (Angola), many of whom were treated with skin scarification before admission. A total of 26 cases were diagnosed from January 2010 to December 2018. None of the cases were confirmed and eight (30.8%) were probable cases according to the Centers for the Disease Control and Prevention anthrax case definition. The median age was 11 (4.7-30.5) years, 17 (65.4%) had lesions on the head, face, or neck and 15 (57.7%) were treated with cutaneous scarification. Nine (34.6%) patients died. Traditional cutaneous scarification was significantly associated with cutaneous superinfection, respiratory, systemic involvement, and death.
Our case series points to increased complications and worse outcome of cutaneous anthrax disease if treated with skin scarification.
炭疽杆菌感染是一种全球性人畜共患病，会影响最脆弱的人群，如果不治疗，死亡率很高，尤其是在非皮肤表现的情况下。在世界上某些地区，皮肤划割术仍然是治疗某些疾病的常用方法，作为传统医学的一部分。我们描述了一组来自安哥拉农村地区的皮肤炭疽病例，这些病例中许多在入院前都接受过皮肤划割术治疗。本研究回顾性观察了 2010 年 1 月至 2018 年 12 月期间在 Cubal（安哥拉）诊断的 26 例皮肤炭疽病例。根据疾病控制和预防中心炭疽病例定义，无确诊病例，8 例（30.8%）为疑似病例。中位年龄为 11 岁（4.7-30.5 岁），17 例（65.4%）病变位于头部、面部或颈部，15 例（57.7%）接受了皮肤划割术治疗。9 例（34.6%）患者死亡。传统的皮肤划割术与皮肤继发感染、呼吸、全身受累和死亡显著相关。
我们的病例系列表明，如果接受皮肤划割术治疗，皮肤炭疽病的并发症和预后更差。
