中国麻风皮肤病杂志 ›› 2021, Vol. 37 ›› Issue (7): 428-432.doi: 10.12144/zgmfskin202107428

• 论著 • 上一篇    下一篇

鱼刺伤肉芽肿10例临床分析

张帆,刘红,暴芳芳,周桂芝,潘晴,张福仁   

  1. 山东第一医科大学附属皮肤病医院（山东省皮肤病医院，山东省皮肤病性病防治研究所），济南，250022
  • 出版日期:2021-07-15 发布日期:2021-06-25
  • 通讯作者: 刘红，E-mail: hongyue2519@hotmail.com

Clinical analysis of 10 patients of fish stab wound granuloma

ZHANG Fan, LIU Hong, BAO Fangfang, ZHOU Guizhi, PAN Qing, ZHANG Furen    

  1. Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Venereology, Shandong First Medical University, Jinan 250022, China
  • Online:2021-07-15 Published:2021-06-25
  • Contact: LIU Hong, E-mail: hongyue2519@hotmail.com

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摘要： 回顾分析2019年1月至2020年5月我院10例鱼刺伤肉芽肿的临床资料及治疗效果。10例患者中，男3例，女7例，平均发病年龄49岁；3例从事与海产相关的厨师职业，5例有鱼类或海鲜刺伤史；1例有菜刀切伤史，1例有手部外伤史。皮损主要表现为上肢红斑、结节，伴破溃结痂。3例患者皮损局限于手部，其余患者皮损沿淋巴管播散。所有患者组织病理检查见上皮样肉芽肿或炎性细胞浸润的非特异性表现。所有患者菌落或皮损组织DNA检测海分枝杆菌qPCR阳性。对皮损局限于手部的3例患者给予米诺环素50 mg,每日2次,平均疗程（4.67±2.08）个月，均痊愈。对6例播散性患者给予利福平150~600 mg联合克拉霉素500 mg每日1次，1例失访，5例痊愈，平均疗程（4.80±1.48）个月。对1例肝功能异常播散性患者给予多西环素100 mg，每日2次，9个月治愈。

关键词: 鱼刺伤肉芽肿, 临床表现, 诊断, 治疗

Abstract: The clinical data of 10 patients with fish stab wound granuloma infection in our hospital from January 2019  to May 2020 were analyzed retrospectively. Of 10 patients, 3 were males and 7 were females with the median age at onset of 49 years. Three patients were seafood chef, 5 had a history of stabbing by fish or seafood, 1 had a history of cutting with kitchen knife and 1 had a history of trauma of hand. The most common lesions were erythema and nodules with ulceration and scab on the upper limbs. The lesions were confined to the hands in 3 patients and the lesions disseminated along the lymphatic vessels in other 7 patients. Histological examination of all patients showed epithelioid granuloma or non-specific manifestations. Mycobacterium marinum was confirmed in the lesion or colonies of 10 patients by qPCR detection. Three patients with localized lesions were treated with minocycline, 50 mg, twice a day, with an average period of treatment of 4.67±2.08 months, and all patients were cured. Six patients with disseminated lesions were treated with rifampicin 150-600 mg combined with clarithromycin 500 mg once a day with an average period of treatment was 4.80±1.48 months, and 5 patients were cured and 1 was lost to follow-up. One patient with disseminated lesions and abnormal liver function was cured after treated with doxycycline, twice a day for 9 months.

Key words: fish stab wound granuloma, clinical manifestation, diagnosis, treatment