每日一题_2024.10.25

A 44-year-old man with Crohn’s disease that was being treated with infliximab presented with a 2-day history of a facial rash. In the previous week, his daughter had had a sore throat, and his mother had developed a similar rash on her face. His heart rate was 96 beats per minute, and his temperature was 36.6°C (97.9°F). Physical examination was notable for well-demarcated, warm, erythematous, confluent plaques on the cheeks, nose, and glabella. The pharynx was normal, and no cervical lymphadenopathy was observed. Which of the following is the most likely culprit organism for the underlying diagnosis?

一名44岁患有克罗恩病的男性正在接受英夫利昔单抗治疗，他出现了2天的面部皮疹病史。在前一周，他的女儿喉咙痛，他的母亲面部也出现了类似的皮疹。他的心率每分钟96次，体温为36.6°C（97.9°F）。体格检查显示，面颊、鼻子和眉间有明显界限、温暖、红斑、融合的斑块。咽部正常，未观察到颈部淋巴结肿大。以下哪种微生物最有可能是潜在诊断的罪魁祸首？

A. Escherichia coli大肠杆菌

B. Pseudomonas aeruginosa铜绿假单胞菌

C. Staphylococcus aureus金黄色葡萄球菌

D. Staphylococcus epidermidis表皮葡萄球菌

E. Streptococcus pyogenes化脓性链球菌

答案解析：

丹毒是一种皮肤感染，涉及上真皮层，通常由化脓性链球菌（A组链球菌）引起。丹毒通常表现为鲜红色的皮疹，经常出现在面部的面颊区域，具有隆起、清晰的边界。大多数病例可以在门诊环境中通过口服抗菌药物进行管理。

正确答案：E