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題名 | Lymphocutaneous Nocardiosis--Two Case Reports=淋巴表皮性土壤絲菌病--兩病例報告 |
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作者 | 廖怡華; 蔡呈芳; 張俊祥; | 書刊名 | 中華皮膚科醫學雜誌 |
卷期 | 15:3 1997.09[民86.09] |
頁次 | 頁162-168 |
分類號 | 415.78 |
關鍵詞 | 淋巴表皮性土壤絲菌病; Nocardiosis; Nocardia brasiliensis; Lymphocutaneous type; Nodular lymphangitis; |
語文 | 英文(English) |
中文摘要 | Two unusual cases of primary lymphocutaneous nocardiosis presenting as a primary inoculation ulcer and ascending nodular lymphangitis are herein reported. Fever and regional lymphadenopathy were also noted.One patient had a definite inoculation history by an abrasion wound that occurred three weeks prior to the development of the skin lesions.Histological examination of the subcutaneous nodules showed neutrophilic infiltration in the lower dermis and subcutaneous layer.Grams stain and modified acid-fast stain of draining pus and skin biopsies showed gram-positive and partialy acid-fast branching filaments, respectively. Nocardia brasiliensis was isolated from the draining pus and skin biopsies of both cases.Patient 1 responded well to oral co-trimoxazole treatment and patient 2 ran a self-limiting course.The unique clinical picture and lack of response to empirical antibiotic treatments should alert clinicians to pursue infectious causes other than pyogenic cellulitis. |
英文摘要 | 我們報告兩例腔見的原發淋巴表皮性土壤絲菌病,病人主訴在下肢出現原發性接 潰瘍和繼發結節性淋巴炎,並伴有發燒及局部淋巴腺腫大。其中一例在皮膚病變出現前三星 期有一確定的創傷病史。皮下結節組織切片顯示在真皮層下方和皮下組織有嗜中性白血球浸 潤。膿及皮膚組織切片顯示革蘭氏陽性及部份抗酸性的分枝絲狀體。兩位病人的膿及皮膚組 織切片培養均分離出Nocardia brasiliensis。第一位病人對口服co-trimoxazole的反應良 好,第二位病人則未經治療自行痊癒。此獨特的臨床表現及對經驗性之抗生素療法缺乏反應 ,應提醒臨床醫師探尋除一般化膿性峰窩組織炎以外的致病原因。 |
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