Tropical ulcers: the first imported cases and review of the literature
| Autor: | Stefano Veraldi, Davide Valentini, S. Bottini, Andrea G. Faraci |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Tropical ulcer Dermatology Bacteria Anaerobic Necrosis Skin Ulcer medicine Humans Medical history medicine.diagnostic_test biology business.industry Bacterial Infections Skin ulcer Middle Aged medicine.disease biology.organism_classification Lymphangitis Fusobacterium Erythrocyte sedimentation rate Female Anaerobic bacteria medicine.symptom business Vasculitis |
| Zdroj: | European journal of dermatology : EJD. 31(1) |
| ISSN: | 1952-4013 |
| Popis: | BACKGROUND A tropical ulcer is a bacterial necrotizing disease of the skin, with an acute or chronic clinical course, caused by anaerobic bacteria, notably Fusobacteria spp. OBJECTIVES We present six Italian tourists who acquired tropical ulcers in tropical and subtropical countries. MATERIALS & METHODS Four males and two females acquired a skin ulcer during trips to Brazil, Malaysia, Fiji Islands, Zambia, Tanzania and India. In all patients, medical history, physical and dermatological examination, laboratory tests, bacteriological examinations and biopsy were carried out. RESULTS All patients were in good general health. All patients stated that the ulcer was caused by a trauma. No fever was reported. Neither lymphangitis nor lymphadenopathy were detected. The ulcer was located on a forearm in one patient, on a leg in two and on an ankle in three patients. All ulcers were malodorous and painful. Laboratory tests revealed mild leucocytosis and a mild increase in erythrocyte sedimentation rate and C-reactive protein. Results of bacteriological examinations revealed the presence of Fusobacterium spp. in five patients. Other bacteria were identified in all patients. Histopathological examination showed: necrosis of the epidermis and dermis; vascular dilatation; oedema in the dermis; massive infiltration with neutrophils, lymphocytes and histiocytes; and fragmented collagen bundles. No signs of vasculitis were observed. All patients were successfully treated with oral metronidazole (1 g/day for two weeks) and, according to antibiograms, with different systemic antibiotics. CONCLUSION To our knowledge, these are the first cases of tropical ulcers reported in Western tourists. |
| Databáze: | OpenAIRE |
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