关键词: 皮肤炭疽, 传染病, 影像学表现, 临床诊断

Abstract: Objective To exploring the imaging manifestations and clinical course of patients with cutaneous anthrax,and to improve the understanding of anthrax. Method Retrospective analysis and summary of the epidemiological history, clinical manifestations, laboratory tests, imaging and treatment of seven patients with cutaneous anthrax admitted to the Third People's Hospital of Kunming from October 2015 to July 2020. Result In the three outbreaks, a total of 14 people were exposed to diseased cattle or sheep, of whom 7 developed the cutaneous anthrax. The patients were 6 males and 1 female, 4 Hui and 3 Han, aged 35-60 years, with a median age of 46 years; the onset was mostly within 7 days after exposure; the lesions first appeared on the hands and forearms, with 6 cases showing papules, 1 case with fluid and pus flowing on the basis of the original hand wound, and in turn with clear herpes, swelling of the surrounding tissues with scab formation, and 1 patient with osteofascial compartment syndrome. Five patients (71.4%) had elevated total peripheral blood leukocyte and neutrophil counts,and six patients (85.7%) had elevated C-reactive protein; two patients (28.6%) had positive Gram-positive bacterial culture of wound secretions; six patients underwent chest CT, all of which showed multiple lymph node enlargement and perilymph node inflammation in the affected axilla, and patients with complicated osteofascial compartment syndrome underwent CT of the upper limbs, which showed soft tissue swelling of the affected limbs. Seven patients were treated with local wet compresses of potassium permanganate and penicillin-based anti-infective therapy, and those with osteofascial compartment syndrome underwent vacuum sealing drainage,all patients were cured. Conclusion Patients with cutaneous anthrax have a clear history of contact with diseased animals and typical skin manifestations; imaging CT examination shows enlarged axillary lymph nodes and perilymph node inflammation; laboratory tests show elevated white blood cell count, neutrophils, and C-reactive protein; early local treatment and full application of antibiotics are the primary treatment.

Key words: Anthrax, Communicable diseases, Imaging, Clinical diagnosis