Cutaneous anthrax in Lima, Peru: retrospective analysis of 71 cases, including four with a meningoencephalic complication
Cutaneous anthrax in Lima, Peru: retrospective analysis of 71 cases, including four with a meningoencephalic complication
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DOI：
10.1590/s0036-46652005000100005
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发表时间：
2005-02-01
期刊：
影响因子：
--
通讯作者：
Solari, Lely
中科院分区：
文献类型：
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作者：
Maguiña, Ciro;Flores del Pozo, Jorge;Solari, Lely
炭疽病是一种由炭疽芽孢杆菌引起的人畜共患病，作为一种人类感染，在世界上的几个地区都是地方病，包括秘鲁。报告的自然获得性感染中95%以上是皮肤感染，其中约5%可进展为脑膜脑炎。在这项研究中，我们回顾了1969年至2002年在秘鲁利马的国家卡耶塔诺医院(HNCH)和热带亚历山大·冯·洪堡医学研究所(Instituto De Medicina Tropical Alexander Von Humboldt)诊断的皮肤炭疽病患者的临床和流行病学特征。71名患者[49/71(69%)为男性]，平均年龄37岁。诊断分为确诊(44%)或可能(56%)。患者最常见的职业是农业(39%)。63例(88.7%)患者有感染源。所有患者均有溃烂病变，中央有坏死。大多数患者(65%)有多个病变，主要位于上肢(80%)。4名患者(5.6%)发展为脑膜脑炎，其中3人最终死亡。总而言之，考虑到其临床和流行病学特征，皮肤炭疽病必须包括在皮肤溃疡的鉴别诊断中。临床上怀疑该病的患者应尽快接受有效治疗，以避免高病死率的神经系统并发症。
Anthrax is a zoonosis produced by Bacillus anthracis, and as an human infection is endemic in several areas in the world, including Peru. More than 95% of the reported naturally acquired infections are cutaneous, and approximately 5% of them can progress to meningoencephalitis. In this study we review the clinical and epidemiological characteristics of the patients with diagnosis of cutaneous anthrax evaluated between 1969 and 2002 at the Hospital Nacional Cayetano Heredia (HNCH) and the Instituto de Medicina Tropical Alexander von Humboldt in Lima, Peru. Seventy one patients were included [49/71 (69%) of them men], with a mean age of 37 years. The diagnoses were classified as definitive (44%) or probable (56%). The most common occupation of the patients was agriculture (39%). The source of infection was found in 63 (88.7%) patients. All the patients had ulcerative lesions, with a central necrosis. Most of the patients (65%) had several lesions, mainly located in the upper limbs (80%). Four patients (5.6%) developed meningoencephalitis, and three of them eventually died. In conclusion, considering its clinical and epidemiological characteristics, cutaneous anthrax must be included in the differential diagnosis of skin ulcers. A patient with clinical Suspicion of the disease should receive effective treatment soon, in order to avoid neurological complications which carry a high fatality rate.