Haut- und Weichteilinfektionen durch Corynebacterium ulcerans – Fallberichte

Zusammenfassung

Anamnese und klinische Befunde Es wird über drei Patienten mit Haut- und Weichteilinfektionen der Unterschenkel durch Toxin-produzierende Corynebacterium-ulcerans-Stämme berichtet. Alle drei Patienten hatten prädisponierende chronische Erkrankungen und lebten mit Katzen bzw. einem Hund in einem Haushalt.

Untersuchungen und Diagnose Aus Wundabstrichen wurde jeweils eine Mischflora einschließlich von Corynebacterium ulcerans angezüchtet. Die Produktion von Diphtherietoxin war in allen drei Fällen nachweisbar.

Therapie und Verlauf Die Haut- und Weichteilinfektionen konnten bei allen drei Patienten durch eine Kombination von Lokalmaßnahmen und Antibiotikatherapie beherrscht werden. Diphtherie-Antitoxin kam nicht zum Einsatz.

Folgerung Basierend auf einer Literaturübersicht werden die wichtigsten Aspekte der Pathogenese, Klinik, Diagnostik und Therapie dieser Infektionen diskutiert. Corynebacterium ulcerans sollte als möglicher Erreger schwerer Haut-, Wund- und Weichgewebe-Infektionen in diagnostische und therapeutische Überlegungen einbezogen und berufliche sowie häusliche Tierkontakte erfragt werden.

Abstract

History and clinical findings We report on three patients suffering from skin and soft tissue infections of the legs due to toxigenic Corynebacterium ulcerans strains. In all three patients, there was a predisposition due to chronic diseases. Three patients had domestic animals (cat, dog) in their households.

Investigations and diagnosis A mixed bacterial flora including Corynebacterium ulcerans was found in wound swab samples. Diphtheric toxin was produced by the Corynebacterium ulcerans strains in all three cases.

Treatment and course In all three patients, successful handling of the skin and soft tissue infections was possible by combining local treatment with antibiotics. Diphtheria antitoxin was not administered in any case.

Conclusion Based on a review of the recent literature pathogenesis, clinical symptoms and signs, diagnostics and therapy of skin and soft tissue infections due to Corynebacterium ulcerans are discussed. Corynebacterium ulcerans should be considered as a potential cause of severe skin and soft tissue infections. Occupational or domestic animal contacts should be evaluated.

Schlüsselwörter

Corynebacterium ulcerans - Haut-Infektionen - Diagnostik - Therapie

Key words

corynebacterium ulcerans - skin infections - diagnostics, therapy

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