plague-like skin lesions
Introduction
Introduction It is the manifestation of the clinical symptoms of Alcaligenes bacilli. Alcaligenetic bacillus pneumonia is a relatively rare bacterial-induced pneumonia. Alcaligenetic bacillus pneumonia is a relatively rare bacterial-induced pneumonia. Infections outside the hospital are more obvious than those in the hospital. They usually have fever, myalgia, joint pain, anorexia, and fatigue. 13% of patients had skin lesions, mainly erythema-like lesions with erythema, nodules, and no eschar or ulcer. The performance of pneumonia has no obvious characteristics with other bacteria, such as cough, chest pain and purulent sputum.
Cause
Cause
(1) Causes of the disease
Alcaligenes are a group of gram-negative bacilli that are specialized in aerobic, motivating, and non-decomposing sugars. It is short rod-shaped, or arc-shaped, without spores, and most without capsules. It is clinically divided into three species, namely Alcaligenes faecalis, Alcaligenes faecalis and A. odorantlon, which are widely found in nature. It is a normal flora in the gut of humans and animals. There are many reports in hospitals, and there are reports of medicinal problems caused by contaminated medical devices.
The bacteria can be isolated from the blood, wound secretions, and feces of patients with sputum, urine, and septicemia. Coexistence of multiple pathogens in infected individuals is common. Two or four kinds of bacteria are common in blood specimens and sputum specimens, and most of the bacteria are Acinetobacter, Pseudomonas, Streptococcus and Bacteroides fragilis. Of course, there are also cases of pure culture. Two cases of sputum specimens reported in the domestic death were pure culture.
(two) pathogenesis
Alcaligenes is a conditional pathogen, which occurs in patients with low immune function. The most common underlying diseases are malignant tumors, as well as cardiovascular diseases, and rare newborns or immature children.
Examine
an examination
Related inspection
Blood test CT examination
Diagnosis: The nutritional requirements of the bacteria are not high. It is grown in a common agar culture dish. It is important to send the specimens in time and recognize that the pathogenicity of the bacteria as a conditional pathogen cannot be ignored.
Laboratory examination: the condition is serious, the patient has high fever, chest pain, hemoptysis, and white blood cells are lower, which is 3.8×109/L.
Other auxiliary examinations: X-ray chest radiographs showed uneven density of large patches in the lungs.
The condition is severe, the patient has high fever, chest pain, hemoptysis and blood stasis, and the white blood cells are lower, which is 3.8×109/L. X-ray chest radiographs showed uneven density of large density in the lungs.
Diagnosis
Differential diagnosis
Common types of lesions
First, primary skin lesions: Primary skin lesions are skin lesions that occur directly in the course of their disease and the first appearance of skin lesions, such as rash, papules, wheal, nodules, herpes, pustules.
1 spotted rash: a noticeable color change for localized skin, no uplift, no depression. The patch is large in size. Divided into red class, pigmentation spots, hypopigmentation spots. Red spot: the fading of the pressure is mostly blood heat; in addition to blood heat, the blood is not fading; the red spot is sparse, the dense is hot, the red is purple and the heat is flaming; the erythema is common It is a skin disease such as erysipelas and drug poisoning. Pigmentation spots: such as chloasma, is caused by liver and kidney deficiency, qi and blood stasis. Hypopigmentation spots: mostly caused by blood stasis or blood deficiency and wind evil, the most common is white barge.
2 pimples: solid hill-shaped small particles higher than the leather surface, the diameter is generally less than 0.5cm, mostly caused by wind and heat, blood heat. The number of papules varies from one to another, and there are scattered distributions. The medical network has collected and merged into a flattened flaky lesion called plaque. The flat top of the papules is called flat papules, which are common in psoriasis, contact dermatitis, and wet sores.
Between the rash and the pimples, the slightly elevated skin lesions are called maculopapular rash. When there is a small blisters or pustules on the top of the pimples, it is called a herpes or a pus.
3 wind group: for the skin on the localized edema uplift, often suddenly, quickly subsided, leaving no traces, accompanied by itching. There are red and white points, red is caused by wind and heat, and white is caused by wind and cold. Common in addiction rash.
4 Nodules: Substantial damages of different sizes and clear boundaries, the quality is hard, deep in the skin or higher than the leather surface, mostly caused by blood stasis, common in nodular erythema and other diseases. 5 herpes is a cavity with a cavity, containing liquid, and higher than the surface. Blood blister is called blood blister in the blister. The blisters are white and the blood blisters are red or purplish red. The blister wall of herpes is generally thin and easy to break, forming a smash after breaking, and scabing after drying. Herpes often occurs on erythema, mostly caused by damp heat or heat, common in wet sores, contact dermatitis, insect bite dermatitis.
6 pustules: blister contains pus, its color is turbid or yellow, often surrounded by red blush, blister formed after erosion, overflowing pus, sputum. Mostly caused by damp heat or heat poisoning, common in impetigo and so on.
Second, secondary skin lesions: is the primary skin lesions after scratching, infection, treatment and evolution in the process of damage repair, scaly, erosion, ulcers, sputum, scratches, cleft palate, moss Deformation, scarring, pigmentation, skin atrophy, etc.
1 scales: the exfoliation of the cuticle of the epidermis, the size and thickness are different, the small is a braided shape, and the large one is a sheet having a diameter of several centimeters or more. Seen after acute illness, most of the residual heat is unclear; chronic diseases are seen, mostly caused by blood deficiency, dryness, and loss of skin.
2 erosion: for the limited epidermal defect, the red wet surface exposed by the rupture of herpes, pustules, and the peeling of the molt, mostly due to damp heat. The erosion is shallower and the wound is faster and does not leave scars.
3 ulcer: a localized defect of the deep dermis or subcutaneous tissue of the skin or mucosa. Ulcers vary in size, with pus, serum or blood on the surface, and necrotic tissue on the base. Mostly it is made of hot and succulent meat. It is often formed by festering, traumatic and other ulceration, and scars are left behind.
4: The exudate, water, oozing or pus in the skin lesions are mixed with the exfoliated tissue and the drug to form a sputum. Purulent sputum is unclear for heat; blood stasis is blood-heat collateral, blood is overwhelmed; phlegm is caused by damp heat.
5 Scratch marks: The linear damage formed by scratching and scratching the epidermis, the surface is bloody, the skin is itchy, mostly caused by wind or internal heat.
6 splitting: It is a linear split on the skin, mostly caused by blood deficiency and wind dryness. Common in the ankle skin lesions keratinized thickening and so on.
7 Moss-like changes: thickening or roughening of the skin, widening of the skin, deepening, dryness, and limited large-scale or small-scale lesions, often the main manifestations of some chronic pruritic skin diseases, mostly caused by blood deficiency , caused by skin dystrophy.
8 pigmentation: caused by the increase of pigment in the skin, mostly brown, dark brown or dark brown. Pigmentation is a primary skin lesion such as chloasma, melanosis, etc., medical education network collection and more caused by liver fire, kidney deficiency; some are secondary skin lesions, such as some chronic skin disease after the local skin pigmentation , mostly due to loss of blood and blood.
