Background: Ecthyma gangrenosum (EG) is an infrequent and discernible cutaneous disease caused by Pseudomonas aeruginosa. In situations where it is associated with septicemia in debilitated patients, the prognosis is ...Background: Ecthyma gangrenosum (EG) is an infrequent and discernible cutaneous disease caused by Pseudomonas aeruginosa. In situations where it is associated with septicemia in debilitated patients, the prognosis is usually unfavorable. Objective: In this case, we aim to verify risk factors, clinical, bacteriological and therapeutic characteristics of ecthyma gangrenosum and we review the literature to highlight the features of this rare condition and discuss the role of early diagnosis and treatment. Case Report: We describe the clinical case of a 4-year-old male with bone marrow aplasia who was presented with characteristic skin lesions of EG and developed sepsis later. Conclusion: EG is a cutaneous disease characterized by its aggressive nature. The presence of delayed diagnosis and therapy, along with sepsis, is closely linked to a high mortality rate. Treatment is empirically founded on an aggressive initial approach.展开更多
Camel contagious ecthyma （CCE） has been reported in Mongolia, Kenya, Somalia and Sudan. CCE is caused by a Parapoxvirus affecting young animals by producing lesions around the lips and nostrils. The generalized form...Camel contagious ecthyma （CCE） has been reported in Mongolia, Kenya, Somalia and Sudan. CCE is caused by a Parapoxvirus affecting young animals by producing lesions around the lips and nostrils. The generalized form of CCE is uncommon. The aim of this study was to submit the first report of contagious ecthyma in Iran and also to help clinician to diagnose this disease with heavy economic losses easier. In the paper, an outbreak of CCE in dromedary and bactrian camels in Qom province of Iran was described and clinical signs were observed in one camel herd in October 2009. Nodules and scabs from seven affected animals were collected for virus identification. Total extracted DNA was used for polymerase chain reaction （PCR） to amplify a fragment of Parapoxvirus B2L gene. Results showed that camel calves （n = 27） less than one year old and one male bactrian camel were affected （no adult female camels were found to be infected）. The prevalence of the disease in the herd, adult camels and camel calves was 30.33%, 1.5% and 100%, respectively. Affected animals showed the swelling of head with nodular lesion around the lips. It then developed to pustules and fissured crusts. Previous involvement with this disease, history of contact with sheep or goats, food resources and season all can have a role in epidemiology of the disease.展开更多
Background and Aim: Ecthyma gangrenosum (EG) is a rare necrotic skin infection caused by Pseudomonas aeruginosa occurring on healthy skin mainly, but not exclusively, in immunocompromised patients. We report the case ...Background and Aim: Ecthyma gangrenosum (EG) is a rare necrotic skin infection caused by Pseudomonas aeruginosa occurring on healthy skin mainly, but not exclusively, in immunocompromised patients. We report the case of EG of unusual presentation in a 12-month-old infant. Case Presentation: This was a 12-month-old male infant who was referred from a peripheral structure for the treatment of facial swelling associated with fever. In his antenatal and intra nasal history, there was a notion of hospitalization for 15 days for early neonatal infection and a delay in psychomotor development. The admission examination showed the fair general condition, hyperthermia at 39°C, tachycardia at 136 beats/minute, and polypnea at 48 cycles/minute. The weight-for-height index with a z-score of 3DS was also found. The dermatological examination at the entrance found an extensive brownish inflammatory tense infiltrated plaque taking the mandibular, submental, retro-auricular occipital regions rapidly evolving towards necrosis, a significant swelling predominant on the upper right eyelid preventing the opening of the associated eyes to mouth ulceration. Biological abnormalities were predominantly neutrophilic leukocytosis, elevated CRP, and elevated muscle enzymes. Microbiological examination of skin samples had isolated Pseudomonas aeruginosa. He had received antibiotic therapy, and a necrosectomy under general anesthesia. The evolution was favorable and he was discharged from the hospital on D26 of hospitalization. Conclusion: This observation is rare due to its location, its early onset, and non-neutropenic background.展开更多
A 43-year-old man with pancytopenia from chemotherapy for acute myeloid leukemia developed left scrotal pain, fever, and rigors. Physical exam revealed an ulcerating lesion with central necrosis and eschar surrounded ...A 43-year-old man with pancytopenia from chemotherapy for acute myeloid leukemia developed left scrotal pain, fever, and rigors. Physical exam revealed an ulcerating lesion with central necrosis and eschar surrounded by a halo of erythema on the inferior aspect of the left scrotum. The condition indicated an early necrofizing soft tissue infection. The patient was started on broad-spectrum antibiotics and taken to the operating room for a wound debridement. Blood and tissue cultures grew Pseudomonas aeruginosa, which confirmed the diagnosis of ecthyma gangrenosum of the scrotum. The fever resolved, and the wound healed without further progression after wet to dry dressing changes.展开更多
目的利用网络药理学分子对接及动物实验探究三妙解毒液外治臁疮的作用机制。方法通过TCMSP数据库筛选三妙解毒液的有效成分及作用靶点;利用Gene Card、OMIM、Pharm Gkb、Drug Bank数据库检索臁疮的疾病靶点,并与三妙解毒液药物靶点取交...目的利用网络药理学分子对接及动物实验探究三妙解毒液外治臁疮的作用机制。方法通过TCMSP数据库筛选三妙解毒液的有效成分及作用靶点;利用Gene Card、OMIM、Pharm Gkb、Drug Bank数据库检索臁疮的疾病靶点,并与三妙解毒液药物靶点取交集;构建三妙解毒液有效成分-作用靶点及蛋白质-蛋白质相互作用网络,通过Cytoscape软件筛选核心靶点基因;通过DAVID数据库进行基因本体(GO)功能富集分析及京都基因与基因组百科全书(KEGG)通路富集分析,微生信平台对结果进行可视化,并构建药物有效成分-臁疮-靶点-通路网络图;利用Auto Dock Tools、Vina及Pymol对药物有效成分与核心靶点进行分子对接。SPF级雄性SD大鼠48只,分为空白组(8只)和造模组(40只)。造模组通过结扎左髂总静脉+局部皮肤全层切除的方法构建臁疮大鼠模型,造模成功后将其分为三妙解毒液低剂量组(0.5 g/ml)、三妙解毒液中剂量组(1.0 g/ml)、三妙解毒液高剂量组(2.0 g/ml)、阳性对照组(牛碱性成纤维细胞生长因子外用溶液)、模型组,每组8只。将无菌纱布修剪成方块,各组分别给予相关药物或0.9%氯化钠注射液溻渍于溃疡创面。RT-q PCR法检测各组AKT1、TP53、MAPK1 m RNA表达水平。结果共检索到三妙解毒液中有效成分367个,潜在作用靶点316个;涉及臁疮靶点2931个,两者共同靶点224个。有效成分包括槲皮素、芹菜素、葛根素等,核心靶点包括AKT1、TP53、MAPK1等。GO富集分析得到生物过程907项、细胞组成113项、分子功能177项。KEGG通路富集分析得到179条信号通路,主要涉及PI3K/Akt、MAPK信号通路等。分子对接结果显示,槲皮素、芹菜素、葛根素可与AKT1、TP53、MAPK1有效结合。动物实验结果显示,模型组AKT1、TP53、MAPK1 m RNA表达低于空白组(P<0.05);三妙解毒液低、中、高剂量组AKT1、TP53、MAPK1 m RNA表达高于模型组(P<0.05);三妙解毒液中剂量组AKT1、TP53、MAPK1m RNA表达高于三妙解毒液低剂量组(P<0.05);三妙解毒液高剂量组AKT1、TP53、MAPK1 m RNA表达低于三妙解毒液中剂量组(P<0.05)。结论三妙解毒液可能通过槲皮素、芹菜素、葛根素等核心活性成分,作用于AKT1、MAPK1、TP53等核心靶点,通过PI3K/Akt、MAPK等信号通路干预臁疮创面的修复。展开更多
文摘Background: Ecthyma gangrenosum (EG) is an infrequent and discernible cutaneous disease caused by Pseudomonas aeruginosa. In situations where it is associated with septicemia in debilitated patients, the prognosis is usually unfavorable. Objective: In this case, we aim to verify risk factors, clinical, bacteriological and therapeutic characteristics of ecthyma gangrenosum and we review the literature to highlight the features of this rare condition and discuss the role of early diagnosis and treatment. Case Report: We describe the clinical case of a 4-year-old male with bone marrow aplasia who was presented with characteristic skin lesions of EG and developed sepsis later. Conclusion: EG is a cutaneous disease characterized by its aggressive nature. The presence of delayed diagnosis and therapy, along with sepsis, is closely linked to a high mortality rate. Treatment is empirically founded on an aggressive initial approach.
文摘Camel contagious ecthyma （CCE） has been reported in Mongolia, Kenya, Somalia and Sudan. CCE is caused by a Parapoxvirus affecting young animals by producing lesions around the lips and nostrils. The generalized form of CCE is uncommon. The aim of this study was to submit the first report of contagious ecthyma in Iran and also to help clinician to diagnose this disease with heavy economic losses easier. In the paper, an outbreak of CCE in dromedary and bactrian camels in Qom province of Iran was described and clinical signs were observed in one camel herd in October 2009. Nodules and scabs from seven affected animals were collected for virus identification. Total extracted DNA was used for polymerase chain reaction （PCR） to amplify a fragment of Parapoxvirus B2L gene. Results showed that camel calves （n = 27） less than one year old and one male bactrian camel were affected （no adult female camels were found to be infected）. The prevalence of the disease in the herd, adult camels and camel calves was 30.33%, 1.5% and 100%, respectively. Affected animals showed the swelling of head with nodular lesion around the lips. It then developed to pustules and fissured crusts. Previous involvement with this disease, history of contact with sheep or goats, food resources and season all can have a role in epidemiology of the disease.
文摘Background and Aim: Ecthyma gangrenosum (EG) is a rare necrotic skin infection caused by Pseudomonas aeruginosa occurring on healthy skin mainly, but not exclusively, in immunocompromised patients. We report the case of EG of unusual presentation in a 12-month-old infant. Case Presentation: This was a 12-month-old male infant who was referred from a peripheral structure for the treatment of facial swelling associated with fever. In his antenatal and intra nasal history, there was a notion of hospitalization for 15 days for early neonatal infection and a delay in psychomotor development. The admission examination showed the fair general condition, hyperthermia at 39°C, tachycardia at 136 beats/minute, and polypnea at 48 cycles/minute. The weight-for-height index with a z-score of 3DS was also found. The dermatological examination at the entrance found an extensive brownish inflammatory tense infiltrated plaque taking the mandibular, submental, retro-auricular occipital regions rapidly evolving towards necrosis, a significant swelling predominant on the upper right eyelid preventing the opening of the associated eyes to mouth ulceration. Biological abnormalities were predominantly neutrophilic leukocytosis, elevated CRP, and elevated muscle enzymes. Microbiological examination of skin samples had isolated Pseudomonas aeruginosa. He had received antibiotic therapy, and a necrosectomy under general anesthesia. The evolution was favorable and he was discharged from the hospital on D26 of hospitalization. Conclusion: This observation is rare due to its location, its early onset, and non-neutropenic background.
文摘A 43-year-old man with pancytopenia from chemotherapy for acute myeloid leukemia developed left scrotal pain, fever, and rigors. Physical exam revealed an ulcerating lesion with central necrosis and eschar surrounded by a halo of erythema on the inferior aspect of the left scrotum. The condition indicated an early necrofizing soft tissue infection. The patient was started on broad-spectrum antibiotics and taken to the operating room for a wound debridement. Blood and tissue cultures grew Pseudomonas aeruginosa, which confirmed the diagnosis of ecthyma gangrenosum of the scrotum. The fever resolved, and the wound healed without further progression after wet to dry dressing changes.
文摘目的利用网络药理学分子对接及动物实验探究三妙解毒液外治臁疮的作用机制。方法通过TCMSP数据库筛选三妙解毒液的有效成分及作用靶点;利用Gene Card、OMIM、Pharm Gkb、Drug Bank数据库检索臁疮的疾病靶点,并与三妙解毒液药物靶点取交集;构建三妙解毒液有效成分-作用靶点及蛋白质-蛋白质相互作用网络,通过Cytoscape软件筛选核心靶点基因;通过DAVID数据库进行基因本体(GO)功能富集分析及京都基因与基因组百科全书(KEGG)通路富集分析,微生信平台对结果进行可视化,并构建药物有效成分-臁疮-靶点-通路网络图;利用Auto Dock Tools、Vina及Pymol对药物有效成分与核心靶点进行分子对接。SPF级雄性SD大鼠48只,分为空白组(8只)和造模组(40只)。造模组通过结扎左髂总静脉+局部皮肤全层切除的方法构建臁疮大鼠模型,造模成功后将其分为三妙解毒液低剂量组(0.5 g/ml)、三妙解毒液中剂量组(1.0 g/ml)、三妙解毒液高剂量组(2.0 g/ml)、阳性对照组(牛碱性成纤维细胞生长因子外用溶液)、模型组,每组8只。将无菌纱布修剪成方块,各组分别给予相关药物或0.9%氯化钠注射液溻渍于溃疡创面。RT-q PCR法检测各组AKT1、TP53、MAPK1 m RNA表达水平。结果共检索到三妙解毒液中有效成分367个,潜在作用靶点316个;涉及臁疮靶点2931个,两者共同靶点224个。有效成分包括槲皮素、芹菜素、葛根素等,核心靶点包括AKT1、TP53、MAPK1等。GO富集分析得到生物过程907项、细胞组成113项、分子功能177项。KEGG通路富集分析得到179条信号通路,主要涉及PI3K/Akt、MAPK信号通路等。分子对接结果显示,槲皮素、芹菜素、葛根素可与AKT1、TP53、MAPK1有效结合。动物实验结果显示,模型组AKT1、TP53、MAPK1 m RNA表达低于空白组(P<0.05);三妙解毒液低、中、高剂量组AKT1、TP53、MAPK1 m RNA表达高于模型组(P<0.05);三妙解毒液中剂量组AKT1、TP53、MAPK1m RNA表达高于三妙解毒液低剂量组(P<0.05);三妙解毒液高剂量组AKT1、TP53、MAPK1 m RNA表达低于三妙解毒液中剂量组(P<0.05)。结论三妙解毒液可能通过槲皮素、芹菜素、葛根素等核心活性成分,作用于AKT1、MAPK1、TP53等核心靶点,通过PI3K/Akt、MAPK等信号通路干预臁疮创面的修复。
