中国麻风皮肤病杂志 ›› 2021, Vol. 37 ›› Issue (12): 759-764.doi: 10.12144/zgmfskin202112759

• 论著 • 上一篇    下一篇

鱼刺伤肉芽肿九例临床分析

冯亚辉1,李仁哲2,严红霞3,史冬梅2，4   

  1. 1 济宁医学院，山东济宁，272001；
    2 济宁市第一人民医院检验科，山东济宁，272001；
    3 济宁市第一人民医院皮肤科，山东济宁，272001；
    4 济宁市第一人民医院医学真菌实验室，山东济宁，272001
  • 出版日期:2021-12-15 发布日期:2021-09-29
  • 通讯作者: 史冬梅，E-mail: shidongmei28@163.com

Clinical analysis of 9 cases with fish stabbing granuloma

FENG Yahui1, LI Renzhe2, YAN Hongxia3, SHI Dongmei2,4   

  1. 1 Jining Medical College, Jining 272001, China; 
    2 Clinical Laboratory, Jining No.1 People's Hospital, Jining 272001, China; 
    3 Department of Dermatology, Jining No.1 People's Hospital, Jining 272001, China; 4 The Laboratory of Medical Mycology, Jining No.1 People's Hospital, Jining 272001, China
  • Online:2021-12-15 Published:2021-09-29
  • Contact: SHI Dongmei, E-mail: shidongmei28@163.com

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摘要： 对2020年8月至2021年4月济宁市第一人民医院确诊的9例鱼刺伤肉芽肿患者的临床资料进行回顾性分析。9例患者（男7例，女2例），年龄21~63岁，均为外伤后发病。3例患者表现为局限斑块型，6例患者表现为沿淋巴管线状分布的暗红色皮下结节。9例患者均行PPD实验，7例阳性。5例患者同期行T-spot实验，3例阳性。其中PPD实验及T-spot实验双重阳性2例，PPD实验阴性T-spot实验阳性1例。飞行时间质谱（MALDI-TOF）及16S核糖体RNA基因测序对菌株鉴定相符率为100%。病理呈感染性肉芽肿改变。治疗包括口服克拉霉素、利福平、异烟肼，光动力治疗及热敷。9例患者中，5例治愈，4例好转。

关键词: 海分枝杆菌, 感染性肉芽肿, 游泳池肉芽肿, 鱼刺伤肉芽肿

Abstract: The data of nine patients (7 males and 2 females) with fish stabbing granuloma from August 2020 to April 2021 were analyzed retrospectively. The patients aged from 21 to 63 years old. Three patients presented with localized plaques and six presented with dark red subcutaneous nodules that along lymphatic vessels. PPD test was performed in all 9 patients and 7 were positive. Of 5 patients who underwent T-spot test, 3 were positive. Of 9 patients, 2 cases were both positive of PPD and T-spot test, 2 were positive of PPD test but negative of T-spot test, 1 was negative of PPD but positive of T-spot test. The coincidence rate of strain identification was 100% by Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF) and 16s ribosomal RNA gene sequencing. The biopsy of lesions showed infectious granulomas. The therapy methods included oral clarithromycin, clarithromycin, rifampicin, isoniazid, topical ALA-PDT and hot pack. Of 9 patients, 5 were cured and 4 significantly improved.

Key words: Mycobacterium marinum, infectious granuloma, swimming pool granuloma, fish stabbing granuloma