小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 坏死性皮肤病变（皮肤炭疽）
- 无痛病变（皮肤炭疽）
- 水肿（皮肤炭疽）
- 流感样表现（吸入性炭疽）
- 呼吸道症状（吸入性炭疽）
- 口咽部溃疡（摄入性炭疽）
其他诊断因素
- 淋巴结肿大
- 低血压
- 胃肠道症状（摄入性炭疽）
危险因素
- 环境暴露
- 职业暴露
- 生物恐怖主义
- 摄入未煮熟的肉
- 海洛因的使用
诊断性检查
首要检查
- 培养和革兰染色
- 实时荧光聚合酶链反应 (RT-PCR)
- 血清学
- 炭疽致死因子 (LF) 毒素质谱分析
- 活检
- 全血细胞计数 (FBC）
- 胸部 X 线检查
需考虑的检查
- 胸部 CT
治疗流程
轻度皮肤炭疽
吸入性、摄入性或重度皮肤炭疽
炭疽脑膜脑炎
撰稿人
作者
Daniel Boyle, MD
Instructor
Division of Infectious Diseases
Northwestern Feinberg School of Medicine
Chicago
IL
利益声明
DB declares that he has no competing interests.
Brian Wolf, MD
Infectious Diseases Fellow
Northwestern Feinberg School of Medicine
Chicago
IL
利益声明
BW declares that he has no competing interests.
鸣谢
Dr Daniel Boyle and Dr Brian Wolf would like to gratefully acknowledge Dr Teresa Zembower and Dr Pavani Reddy, previous contributors to this topic. TZ and PR declare that they have no competing interests.
同行评议者
Timothy Benton, MD
Regional Chairman
Residency Program Director
Associate Professor
Family and Community Medicine
Texas Tech University Health Sciences Center at the Permian Basin
Odessa
TX
利益声明
TB declares that he has no competing interests.
Raffaele D’Amelio, MD
Professor of Internal Medicine
Director: Unit Clinical Immunology and Allergy
Department of Clinical and Molecular Medicine
Sapienza University of Rome, S. Andrea University Hospital
Rome
Italy
利益声明
RD declares that he has no competing interests.
Ali Hassoun, MD, FACP, FIDSA, AAHIVS
Infectious Disease Specialist
Alabama Infectious Diseases Center
Huntsville
AL
利益声明
AH declares that he has no competing interests.
Tim Brooks, MA, LMSSA, MB BChir, MSc, FRCPath, FRSPH
Head of Novel & Dangerous Pathogens
Novel and Dangerous Pathogens
HPA Centre for Emergency Preparedness and Response
Salisbury
UK
利益声明
TB declares that he has no competing interests.
鉴别诊断
- 细菌性疖病
- 坏死性脓疮
- ORF（深脓疱传染性软疣）
更多 鉴别诊断指南
- 国际旅行健康信息（黄皮书）—炭疽
- 美国炭疽疫苗的使用：2019 年免疫接种实践咨询委员会的推荐
更多 指南
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