Sotto M N, Langer B, Hoshino-Shimizu S, de Brito T
J Infect Dis. 1976 May;133(5):506-14. doi: 10.1093/infdis/133.5.506.
Biopsy specimens of the skin were taken from 10 patients with acute meningococcemia who exhibited mainly maculopurpuric lesions. The specimens were studied by light, electron, and immunofluorescent microscopy in an attempt to obtain information on the pathogenesis of vascular injury. Light microscopy disclosed a large number of Neisseria meningitidis organisms, both in the endothelial cells and being phagocytized by neutrophils. Vascular injury was characterized (by means of both light and electron microscopy) by endothelial necrosis, thrombosis, and necrosis of other elements of the vascular wall, such as muscle cells and pericytes. Immunoglobulins and complement were also found in the vascular wall in most cases. Hypercoagulability was demonstrated in some patients. These findings suggest that the cutaneous lesions of meningococcemia fulfill most of the gross and histologic criteria of the local Shwartzman reaction, but that immunological factors probably contribute to pathogenesis.
从10例主要表现为斑丘疹性病变的急性脑膜炎球菌血症患者身上获取皮肤活检标本。对这些标本进行了光镜、电镜和免疫荧光显微镜检查，试图获取有关血管损伤发病机制的信息。光镜检查发现大量脑膜炎奈瑟菌，存在于内皮细胞中并被中性粒细胞吞噬。通过光镜和电镜观察，血管损伤的特征为内皮坏死、血栓形成以及血管壁其他成分（如肌肉细胞和周细胞）的坏死。大多数病例中，血管壁内还发现了免疫球蛋白和补体。部分患者表现出高凝状态。这些发现表明，脑膜炎球菌血症的皮肤病变符合局部施瓦茨曼反应的大多数大体和组织学标准，但免疫因素可能在发病机制中起作用。
