Changes in skin bacterial flora during the healing process of ulcer caused by self-destruction of lymph nodes due to tuberculous lymphadenitis

IF 2.9 3区 医学 Q2 DERMATOLOGY
Makoto Kondo, Daiki Goto, Koji Habe, Naohisa Yamazoe, Keiichi Yamanaka
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Abstract

An 86-year-old woman with residual left hemiplegia from a prior stroke, residing in a nursing facility, presented with swelling of the right side of her neck. Tuberculous lymphadenitis was diagnosed through polymerase chain reaction analysis and sputum culture, leading to treatment with isoniazid, rifampicin, and ethambutol. After 2 months, an abscess and ulcer formed; analysis of the bacterial flora of the ulcer revealed a Pseudomonas infection. Treatment with a topical iodine-containing ointment eradicated the Pseudomonas and led to increased diversity with the emergence of species from the Eukaryota and Archaea kingdoms. Subsequently, a loss of diversity occurred, ultimately resulting in a dominance of Escherichia-Shigella. We suggest that the bacterial flora of early ulcers may be dominated by multidrug-resistant Pseudomonas. Escherichia-Shigella may emerge during the ulcer healing process. We, therefore, strongly encourage recognition of the fact that individuals with tuberculosis are immunocompromised and emphasize the critical importance of early intervention in such infections.

Abstract Image

结核性淋巴结炎导致淋巴结自毁引起的溃疡愈合过程中皮肤细菌群的变化。
一位 86 岁的妇女因中风而遗留左侧肢体偏瘫,现住在一家护理机构,她的右侧颈部肿胀。通过聚合酶链反应分析和痰培养确诊为结核性淋巴结炎,并接受了异烟肼、利福平和乙胺丁醇治疗。2 个月后,脓肿和溃疡形成;溃疡细菌菌群分析显示是假单胞菌感染。使用局部含碘软膏治疗后,假单胞菌被根除,并出现了真核生物界和古生菌界的物种,从而增加了细菌的多样性。随后,多样性逐渐丧失,最终导致埃希氏菌占主导地位。我们认为,早期溃疡的细菌菌群可能以耐多药假单胞菌为主。在溃疡愈合过程中可能会出现志贺氏菌。因此,我们强烈鼓励认识到结核病患者免疫力低下的事实,并强调对此类感染进行早期干预的极端重要性。
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来源期刊
Journal of Dermatology
Journal of Dermatology 医学-皮肤病学
CiteScore
4.60
自引率
9.70%
发文量
368
审稿时长
4-8 weeks
期刊介绍: The Journal of Dermatology is the official peer-reviewed publication of the Japanese Dermatological Association and the Asian Dermatological Association. The journal aims to provide a forum for the exchange of information about new and significant research in dermatology and to promote the discipline of dermatology in Japan and throughout the world. Research articles are supplemented by reviews, theoretical articles, special features, commentaries, book reviews and proceedings of workshops and conferences. Preliminary or short reports and letters to the editor of two printed pages or less will be published as soon as possible. Papers in all fields of dermatology will be considered.
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