ABSTRACT
ABSTRACT China's compulsory annual livestock anthrax vaccination policy has remarkably reduced but not completely eradicated human anthrax infections. Herein we describe a sporadic human cutaneous anthrax outbreak involving two cases in 2018 in Shaanxi Province, both involving herdsman who dealt with unvaccinated and potentially sick cattle. Both patients showed Bacillus anthracis-positive blister smear and blood culture. Treatment with penicillin was followed by uneventful recovery for both. The prompt performance of the prophylactic measures successfully interrupted the further transmission of this sporadic human cutaneous anthrax outbreak.
Subject(s)
Humans , Male , Adult , Skin Diseases, Bacterial/pathology , Anthrax/pathology , Penicillins/therapeutic use , Bacillus anthracis/isolation & purification , China/epidemiology , Disease Outbreaks , Treatment Outcome , Skin Diseases, Bacterial/drug therapy , Skin Diseases, Bacterial/epidemiology , Anthrax/drug therapy , Anthrax/epidemiology , Anti-Bacterial Agents/therapeutic useABSTRACT
El carbunco cutáneo es una zoonosis cuyo diagnóstico clínico es fácil de conseguir, aunque en muchas ciudades, en donde su incidencia es baja, 0 en lugares apartados donde el medico está aislado, el diagnostico puede tener dificultades. Se presentan dos casos sospechosos de carbunco cutáneo en estadío avanzado, procedentes de una zona enzootia de carbunco; en ambos pacientes, se realizó estudio histopatológico de las lesiones cutáneas, en ambos casos se detectó necrosis de coagulación asociado a costra hemorrágica. En el resto de la epidermis se observaron signos de hiperplasia epitelial, papilomatosis, acantosis, hiperqueratosis, paraqueratosis. La ausencia de complicaciones en la biopsia de piel, similar a la observada en la reciente epidemia norteamericana por bioterrorismo, demuestra que puede ser usada como un método seguro cuando se dificulte el diagnóstico clínico El patrón histopatológico de necrosis de coagulación asociado a costra hernorrágica puede ser considerado uno de los signos hepatológicos más característicos de carbunco cutáneo en lesiones avanzadas y un cuarto criterio diagnóstico, alternativo al clínico, epidemiológico y de laboratorio, en la definición de los casos sospechosos de carbunco.
Cutaneous anthrax is a zoonosis which clinical diagnostic is easy to get it although in many cities where it's incidence is low, or in remote areas where the doctor is isolated, it's diagnostic can be difficult. It shows two patients suspects cutaneous anthrax in advanced stage, they from anthrax enzootic area; in both patients histopathological study of cutaneous lesions was conducted, this histopathological study show clotting necrosis associated to hemorrhagic scabs Signs of epithelial hyperplasia, papilomatosis, acantosis, hiperqueratosis, and paraqueratosis were seen surrounding the necrotized epidermis. The absence of complications in skin biopsy is similar at that observed in northeamerican bioterrorism outbreak and demonstrates that may be used as a safe method in some situations when clinical diagnosis difficult. The histophathological pattern of clotting necrosis associated to haemorrhagic scabs can be considered one of the more characteristics histopathological signs of cutaneous anthrax in advanced stage and fourth diagnostic criterion, alternative to clinical, epidemiological and laboratory, in the definition of suspected cases of anthrax.
Subject(s)
Humans , Male , Adult , Female , Aged , Anthrax/pathology , Necrosis , ZoonosesABSTRACT
Con el objetivo de describir las manifestaciones clínicas de pacientes con meningoencefalitis por tuberculosis (TBC), se realizó un estudio descriptivo, retrospectivo mediante la revisión de historias clínicas de 15 pacientes adultos, evaluados por el servicio de Neurología en el SAHUM durante el periodo de Enero 2002 a Diciembre 2008. Se analizó: edad, sexo, procedencia, manifestaciones clínicas, tiempo entre el inicio de los síntomas y la hospitalización y tratamiento. De los 15 pacientes, 10 (66,67%) fueron de sexo femenino, 9 (60,0%) entre 20 y 29 años de edad. El 53,34% eran procedentes de los Municipios Mara y Páez. Las manifestaciones clínicas fueron; cefalea y rigidez de nuca 14 (93,33%), alteración de la consciencia 13 (86,67%), alteración mental 7 (46,66%), convulsión 8 (53,33%), hipertensión intracraneana 5 (33,33%), déficit Motor 3 (20,00%), alteración de pares craneales 2 (13,33%) como falso signo localizador y en 2 (13,33%) diplopía. La citoquímica del líquido cefalorraquídeo reveló hipoglucorraquia en el 100,00% de los pacientes e hiperproteinorraquia. La coloración de Ziehl Neelsen fue positiva en 1 (6,67%). 6 pacientes (40,00%) tenían más de 1 mes con TBC. Se concluye que son diversas las manifestaciones clínicas de meningoencefalitis por TBC, siendo más frecuente el síndrome meníngeo
With the objective of describing clinical manifestations in patients with meningeal encephalitis due to tuberculosis (TBC), a descriptive, retrospective study was made by reviewing clinical histories of 15 adult patients with a diagnosis of TBC in the SAHUM neurology service from January 2002 to December 2008. Age, sex, clinical manifestations, hospitalization and treatment were analyzed. Of the 15 patients, 10 (66.67%) were female, 9 (60.0%) were between 20 and 29 years of age; 53.34% came from the Mara and Páez Municipalities. The clinical manifestations were: headache and nape of the neck rigidity, 14 (93.33%); alteration of consciousness, 13 (86.67%); alteration of mental state, 7 (46.66%); convulsions, 8 (53.33%); intracranial hypertension, 5 (33.33%); motor deficit, 3 (20.00%); alteration of cranial pairs, 2 (13.33%) as a false locator sign and diplopia, 2 (13.33%). Cytochemical study of the cerebrospinal fluid revealed hypoglycorrhachia in 100.00% of the patients. Ziehl Neelsen coloration was positive in 1 (6.67%). Six patients (40.00%) had had the disease for more than 1 month. Conclusions were that the clinical manifestations of meningeal encephalitis due to TBC are diverse, with the meningeal syndrome as the most frequent
Subject(s)
Humans , Male , Adult , Female , Anthrax/pathology , Meningoencephalitis/diagnosis , Tuberculosis/pathologyABSTRACT
The clinical features of ten cases of cutaneous anthrax are reported. Six males and four females were affected. Their ages ranged from one and a half year to sixty years. The average incubation period was 8 days. Fever and headache were common systemic manifestations. Pruritus and ulcer with formation of black eschar were typical features. The patients were treated with penicillins and chloramphenicol. There was no mortality. Possible human-to-human spread in a patient is discussed.