摘要目的 探讨皮肤炭疽患者的流行病学和临床特征.方法 回顾性分析2015年7月至12月延安市21例皮肤炭疽患者的流行病学资料、临床资料,对患者的一般资料、流行病学特点、临床症状、实验室检查、治疗方案和转归进行分析.结果 21例皮肤炭疽患者均在接触病死牲畜后出现皮肤火山口样溃疡,部分患者出现发热、头痛、腹泻、淋巴结肿大;2例患者皮肤损伤分泌物细菌涂片见革兰阳性杆菌,细菌呈两端截平,呈竹节状排列,其中1例细菌培养见需氧芽孢杆菌,且噬菌体试验、青霉素纸片试验均为阳性.21例患者经青霉素治疗后均痊愈.结论 接触不明原因病死畜后皮肤出现火山口样溃疡和焦痂,需高度警惕炭疽杆菌感染;及时采集标本行病原学检查可协助明确诊断;早期青霉素抗感染是控制病情、彻底治愈皮肤炭疽的有效疗法;及早上报疫情、加强炭疽知识的宣传是防控疫情扩散的关键措施.

abstractsObjective To investigate the epidemiology and clinical characteristics of 21 cases with human cutaneous anthrax.Methods The clinical manifestations and epidemic data of twenty-one human cutaneous anthrax cases from July to December in 2015 in Yan'an City,Shaanxi Province were reviewed.Their demographic data,epidemic features,clinical manifestations,laboratory results,treatment regimen and outcomes were retrospectively analyzed.Results All the 21 patients had previous contact history with the dead mules or donkeys before the onset of crater-like skin ulcer,and some of them presented with fever,headache,diarrhea and lymphadenoma.Gram-positive bacillus,which had squared ends and endospores,was found in the skin secretions of two patients and positive aerobic culture of spore-forming bacillus was found in one patient,with positive phage test and penicillin G susceptibility test.All patients cured after individualized penicillin treatment.Conclusions When the patient presents with crater-like skin ulcers and eschar after contacting with the dead livestock,anthrax infection should be carefully ruled out.Timely sample collection and etiological examination can help make the diagnosis of human cutaneous anthrax.Early administration of penicillin is important for infection control and disease cure.Early disease reporting and relevant knowledge propaganda are the key measures to prevent and control the transmission of the disease.