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7 岁儿童严重蚊咬过敏并发细菌感染:一例病例报告及文献简要回顾

英文原题:Severe mosquito bite allergy complicated by bacterial infection in a 7-year-old child: a case report and brief review of the literature.

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Severe mosquito bite allergy complicated by bacterial infection in a 7-year-old child: a case report and brief review of the literature.

PubMed 2023/11/01(内容时间) Wounds Q3 · IF 1(JCR 2025)

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研究概要

SMBA 是 CAEBV 的一种亚型,其特征为严重的皮肤溃疡,且容易被漏诊或误诊。

中文摘要

引言:严重蚊虫叮咬过敏(SMBA)是慢性活动性EB病毒感染(CAEBV)的一种皮肤型,主要见于东亚国家的青少年和儿童。其特征为蚊虫叮咬后出现局部皮肤红斑、水疱、大疱、溃疡、坏死和瘢痕。患者可能出现类似传染性单核细胞增多症(IM)的全身炎症反应。SMBA主要累及NK细胞,并可能进展为NK/T细胞淋巴瘤或侵袭性NK细胞白血病。 病例报告:一名7岁女童因反复发热、皮肤过敏以及累及双下肢的多灶性严重溃疡坏死性皮损入院。作者最初怀疑细菌感染,但清创不足以控制病情。坏死病灶周围残余皮肤组织的病理检查发现EBER阳性T细胞。最终依据诊断标准和病理结果,患者被诊断为SMBA合并细菌感染。及时给予抗病毒和抗菌治疗后患者反应良好,定期随访期间病情未恶化。 结论:SMBA是以严重皮肤溃疡为特征的CAEBV亚型,容易漏诊或误诊。结合蚊虫叮咬史、病理特征及实验室指标,SMBA有望拓展溃疡性皮肤病的新诊断和治疗途径。

展开英文摘要原文

INTRODUCTION: SMBA is a cutaneous form of CAEBV that predominantly affects adolescents and children from East Asian countries. It is characterized by local skin erythema, bullae, ulcers, necrosis, and scarring following a mosquito bite. Affected patients may experience IM-like systemic inflammatory reactions. SMBA mainly involves NK cells and has the potential to progress to NK/T-cell lymphoma or invasive NK-cell leukemia. CASE REPORT: A 7-year-old female was admitted to the hospital owing to recurring fever, skin allergies, and multifocal severe ulcerative necrotic skin lesions affecting both lower limbs. The authors primarily suspected bacterial infection, and debridement was insufficient to manage it. Pathological examination of residual skin tissues around the necrotic lesion revealed EBER-positive T cells. Eventually, the patient was diagnosed with SMBA complicated by bacterial infection based on diagnostic criteria and pathology findings. The patient responded well to timely antiviral and antibacterial treatment, with no deterioration during regular follow-up visits. CONCLUSIONS: SMBA is a subtype of CAEBV that is characterized by severe skin ulceration and is easily missed or misdiagnosed. Based on its mosquito bite history, pathological characteristics, and laboratory indicators, SMBA could expand new diagnostic and therapeutic approaches to the ulcerative skin diseases.

论文信息

作者
Wang Y、Xia Z、Fang L
第一作者单位
Clinicopathological Center, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, Hefei, China.China
通讯作者单位
Department of Wound Repair and Plastic and Aesthetic Surgery, The First Affiliated Hospital of Anhui Medical University, Anhui Public Health Clinical Center, Hefei, China.China
文献类型
综述 · 病例报告
期刊
Wounds : a compendium of clinical research and practice2023 Nov
原文标识
PubMed 38048618 · DOI 10.25270/wnds/23067