Sequelae of World War II: an outbreak of chronic cutaneous nontuberculous mycobacterial infection among Satowanese islanders.
Sequelae of World War II: an outbreak of chronic cutaneous nontuberculous mycobacterial infection among Satowanese islanders.
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第二次世界大战的后遗症：萨托万岛民爆发慢性皮肤非结核分枝杆菌感染。
DOI：
10.1086/598928
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发表时间：
2009
期刊：
影响因子：
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通讯作者：
Winthrop,KevinL
中科院分区：
文献类型：
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作者：
Lillis,JosephV;Ansdell,VernonE;Ruben,Kino;Simpson,EricL;Tumbaga,Gloria;Ansdell,David;Bremmer,Samuel;Kurtz,StephenE;WhiteJr,CliftonR;Blauvelt,Andrew;Winthrop,KevinL
背景：第二次世界大战后，密克罗尼西亚联邦楚克州外岛 Satowan（人口 650 人）的居民注意到一种当地称为“垃圾邮件”的慢性进行性皮肤病的高患病率。方法。患有慢性进行性疣状或瘢痕疙瘩超过 3 个月的岛上居民被视为病例患者。获取组织标本进行培养、组织病理学分析、分枝杆菌聚合酶链反应（PCR）以及与海分枝杆菌hsp65基因的比较。我们对所有病例和从社区中随机选择的对照个体进行病例对照研究。结果。共鉴定出39例患者，中位年龄为26.0岁（范围为8-82岁）； 74.4%为男性，平均病程为12.5年。总共招募了 98 名对照个体。所有19个分枝杆菌组织培养结果均为阴性，所有9个病灶的组织病理学分析均显示化脓性肉芽肿性炎症，分枝杆菌和真菌染色结果均为阴性。 9个石蜡包埋样品中，有7个通过PCR检测到非结核分枝杆菌DNA，2个测序产物与M的同一性分别为95%和87%。 marinum.所有病例均为芋农（优势比，未定义；P<.01），在芋农中，当分析控制性别时，接触充满水的二战时期炸弹坑与感染相关（优势比，8.2；P<.01）。结论。“垃圾邮件病”是佐藤湾地区高发率的一种慢性进行性皮肤病，与种植芋头和接触二战时期炸弹有关。陨石坑。组织病理学和 PCR 数据表明非结核分枝杆菌感染是病因。
Background.After World War II, residents of Satowan (population, 650 persons), an outer island in the state of Chuuk, Federated States of Micronesia, noted a high prevalence of a chronic, progressive skin disease known locally as “spam.”Methods.Island residents who had chronic, progressive verrucous or keloidal plaques for >3 months were considered case patients. Tissue specimens were obtained for culture, histopathological analysis, mycobacterial polymerase chain reaction (PCR), and comparison with thehsp65gene ofMycobacterium marinum.We performed a case-control study involving all cases and randomly selected control individuals from the community.Results.A total of 39 case patients were identified, with a median age of 26.0 years (range, 8–82 years); 74.4% were male, and the mean duration of disease was 12.5 years. A total of 98 control individuals were enrolled. Results of all 19 mycobacterial tissue cultures were negative, and histopathological analysis of all 9 lesions showed suppurative granulomatous inflammation with negative results of mycobacterial and fungal stains. In 7 of 9 paraffin-embedded samples, nontuberculous mycobacterial DNA was detected by PCR, and 2 sequenced products had 95% and 87% identity toM. marinum.All case patients were taro farmers (odds ratio, undefined; P<.01), and among taro farmers, when the analysis was controlled for sex, contact with water-filled World War II-era bomb craters was associated with infection (odds ratio, 8.2; P<.01).Conclusions.“Spam disease” is a chronic, progressive skin disease of high prevalence on Satowan and is associated with taro farming and contact with World War II-era bomb craters. Histopathological and PCR data demonstrate a nontuberculous mycobacterial infection as the cause.