Tanasescu S, Joly P, Le Corvaisier-Pieto C, Dujardin F, Latouche J B, Lauret P
Clinique Dermatologique, Hôpital Charles Nicolle, Rouen.
Ann Dermatol Venereol. 1996;123(12):804-6.
Domestic animal bites or scratches are quite frequent. Among banal bacteria isolated from infected bites or scratches, group A streptococcus seems to be frequently associated with severe infections.
Three cases of acute necrotizing cutaneous streptococcal infections, following cat or dog bite or scratch are reported. Twice, group A streptococcus was isolated from cutaneous swabs. In the third case, previous antibiotic therapy had sterilised bacteriological samples. Diagnosis was ascertained on the basis of clinical presentation and significant antistreptococcal antibodies elevation. Skin necrosis around the inoculation area was observed in the 3 cases. Cicatrisation required an average of two months under appropriate treatment.
An evolution towards cutaneous necrosis localized to the initially injured area is common to these three cases. This peculiar evolution is worth to be known in order to choose an effective anti streptococcal antibiotherapy whenever domestic animals bites and scratches are to be treated.
家畜咬伤或抓伤十分常见。在从感染的咬伤或抓伤处分离出的常见细菌中,A 组链球菌似乎常常与严重感染相关。
报告了三例猫或狗咬伤或抓伤后发生的急性坏死性皮肤链球菌感染病例。有两次从皮肤拭子中分离出 A 组链球菌。在第三例中,先前的抗生素治疗已使细菌学样本无菌。根据临床表现和显著的抗链球菌抗体升高确定诊断。3 例均观察到接种部位周围的皮肤坏死。在适当治疗下,愈合平均需要两个月。
这三例病例的共同特点是向最初受伤部位的皮肤坏死演变。了解这种特殊的演变情况对于在治疗家畜咬伤和抓伤时选择有效的抗链球菌抗生素治疗很有必要。