中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (7): 477-480.doi: 10.12144/zgmfskin202607477

• 新发与再发感染性皮肤病 • 上一篇    下一篇

宏基因组二代测序辅助诊断误诊为羊痘的皮肤炭疽一例

申鑫1,张颖琦1,张强2,乌日嘎1   

  1. 1内蒙古医科大学附属医院皮肤科，内蒙古呼和浩特，010050；2内蒙古医科大学，内蒙古呼和浩特，010050
  • 出版日期:2026-07-15 发布日期:2026-06-29

Cutaneous anthrax misdiagnosis as orf and confirmed with the metagenomic next-generation sequencing: a case report

SHEN Xin1, ZHANG Yingqi1, ZHANG Qiang2, WU Riga1   

  1. 1 Department of Dermatology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China; 2 Inner Mongolia Medical University, Hohhot 010050, China
  • Online:2026-07-15 Published:2026-06-29

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摘要： 患者，男，58岁。右前臂紫红色斑块、溃疡10天，发热2天。有病羊接触史。组织病理无典型特征。炭疽核酸检测阴性。分泌物细菌培养表皮葡萄球菌阳性，初诊为羊痘，予美罗培南联合利奈唑胺静点，有效。但考虑患者曾高热39.6℃，皮损表现高度疑似炭疽，取溃疡组织行病原学微生物宏基因组DNA检测(mNGS-DNA)提示炭疽杆菌阳性。予青霉素联合利奈唑胺继续抗感染2天，红肿逐渐消退，皮损处水疱干涸,黑痂逐渐脱落，转传染病医院进一步隔离治疗。

关键词: 皮肤炭疽, 羊痘, 宏基因组二代测序

Abstract: A 58-year-old male patient presented with a 10-day history of purplish-red plaques and ulcers on the right forearm and a 2-day history of fever, with a history of exposure to sick sheep. No typical pathological features were observed on histological examination. The nucleic acid test for Bacillus anthracis was negative, and bacterial culture of the lesion secretion yielded positive for Staphylococcus epidermidis. The patient was initially diagnosed with sheep pox and treated with intravenous meropenem combined with linezolid, which achieved a certain therapeutic effect. However, considering that the patient had a high fever of 39.6℃ and the skin lesions were highly suspicious for anthrax, ulcer tissue specimens were collected for metagenomic next-generation sequencing of microbial DNA (mNGS-DNA). The sequencing result was positive for Bacillus anthracis. The anti-infective regimen was adjusted to penicillin combined with linezolid for continuous treatment for 2 days. Subsequently, the local swelling gradually subsided, the blisters on the skin lesions dried up, and the black eschar gradually fell off. The patient was then transferred to a specialized infectious disease hospital for further isolated treatment.

Key words: cutaneous anthrax, orf, metagenomic next-generation sequencing (mNGS)