CAJ | 학술논문

感染性肉芽肿是一类慢性增生性炎症。放线菌和诺卡菌所致感染性肉芽肿实属少见，但两者临床症状、体征相似，易误诊或漏诊。本文报道1例放线菌与1例诺卡菌所致皮肤感染性肉芽肿，通过皮肤组织病理学检查、细菌培养、生化鉴定及细菌分子生物学检测，最终明确诊断。进一步分析2种感染的病因学、流行病学、临床表现、诊断和鉴别诊断及治疗，并结合最新研究进展，可帮助临床医师更好地认识放线菌属细菌所致感染性皮肤肉芽肿，以便于及时诊断、及时治疗。这2种感染有很多相似之处，也有各自特点，需临床医师求同存异，仔细鉴别；还需与其他感染性肉芽肿如皮肤结核、孢子丝菌病或着色芽生菌病等鉴别诊断。
감염성육아종시일류만성증생성염증。방선균화낙잡균소치감염성육아종실속소견，단량자림상증상、체정상사，역오진혹루진。본문보도1례방선균여1례낙잡균소치피부감염성육아종，통과피부조직병이학검사、세균배양、생화감정급세균분자생물학검측，최종명학진단。진일보분석2충감염적병인학、류행병학、림상표현、진단화감별진단급치료，병결합최신연구진전，가방조림상의사경호지인식방선균속세균소치감염성피부육아종，이편우급시진단、급시치료。저2충감염유흔다상사지처，야유각자특점，수림상의사구동존이，자세감별；환수여기타감염성육아종여피부결핵、포자사균병혹착색아생균병등감별진단。
Infections granuloma is a kind of chronic hyperplastic inflammation which is rarely caused by Actinomyces and Nocardia .As clinical symptoms and physical examination results of infectious granuloma caused by Actinomyces and Nocardia are similar ,it is easily to lead to misdiagnosis or missed diagnosis .Here we presented a case of infectious granuloma caused by Actinomyces and a case of infectious granuloma caused by Nocardia . The final diagnosis was confirmed by pathological examination , bacterial culture and identification ,and gene sequencing . We also summarized the etiology , epidemiology , clinical features , differential diagnosis ,treatment and recent advances in these two infections ,which could help to make the correct diagnosis without delay and choose the optimal treatment . There two infections have many similarities ,and we need to distinguish them for proper therapy . The differential diagnosis with other granulomatous infections ,such as tuberculosis ,cutaneous sporotrichosis or chromoblastomycosis was also discussed .