「Dermatological mycobacterium infecions」の版間の差分
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**occupation, living place, triggering event | **occupation, living place, triggering event | ||
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==cutaneous TB== | ==cutaneous TB== | ||
2021年5月30日 (日) 17:01時点における版
目次
skin mycobacterial diseases
- leprosy
- only in human
- cutaneous TB
- only in human
- non-TB mycobacterium (NTM)
- water-borne
when to suspect
- skin symptoms WITHOUT inflammatory sings (pain, swelling, redness)
- slow progression
- specific patient background
- occupation, living place, triggering event
cutaneous TB
- estimated 1-2% of all TB patients
- diverse range of symptoms
route of transmission
- exogenous inoculation
- ulcer,
- tuberculosis verrucosa cutis, warty tuberculosis
- orificial tuberculosis - direct contact of M.t. contained in sputum from pulmonary TB
- endogenous spread from internal TB
- abscess,
- scrofuloderma - emerged from lymphadenitis
- hematogenous
- nodule, abscess, patch
- as part of miliary tuberculosis
- immunocompromised host, children
- tuberculid - allergic reaction against M. tuberculosis
- erythema, papule
- in immunocompetent patient
- skin biopsy of the eruption shows no bacteria
- strong positivity of Mantoux test
- Bazin erythema
- usually localized to lower legs
treatment
- same as of systemic tuberculosis
skin NTM
all manifest in similar skin lesions, eruptions
- M. ulcerans = Buruli ulcer
- M. chelonae
- M. marinum - highest incidence
- contact with tropical fish
- M. avium
- long-maintained hot bath
- hot spring
- M. peregrinum
- M. massiliense (M. abscessus subsp. massiliense)
treatment
- use more than two antibiotics to prevent from resistance
- clarithromycin, rifampicin, quinolone, minocycline..
- NO standarized regimen nor treatment duration
Buruli ulcer
diagnosis
- mandatory
- skin manifestation
- histopathology
- PCR
- indigenous Buruli ulcer in Japan
- M. ulcerans subsp. shinshuense
- total 76 cases during 1980-2020
- in all age
- 感染研：ブルーリ潰瘍
