外伤后细菌性致死性肉芽肿的透射电镜观察

目的：外伤后细菌性致死性肉芽肿是一种尚未被认识的新疾病，近20a来在我国多个地区已发现20余例，无一存活。本研究 应用透射电镜寻找病原体，为该病的诊断和治疗提供线索。方法：以透射电镜观察2例外伤后细菌性致死性肉芽肿的活检组织，寻找该病的病原。结果：病变组织内主要为组织细胞、多核巨细胞，细胞内有大量溶酶体样结构，部分溶酶体样结构具有“杆菌”形态，另见少数球菌。根据电镜下的发现成功分离出1种严格的厌氧性细菌，初步确定为放线菌，并根据细菌药敏结果救活了1例患。结论：对于怀疑由病原体所致的疾患，电镜下发现损害中的病原体是最具说服力的证据，本病的发现和命名，电镜发挥了关键作用。

Observation of fatal bacteria granuloma after trauma on transmission electron microscopy

AIM Fatal Bacteria Granuloma after Trauma is a new kind of disease that has not been recognized. More than 20 cases of the disease have been noticed in China during the past 20 years. No patient had been saved till recently. The aim was to probe into the pathogen of the disease and save the patients' life. METHODS Tissues from the lesion of patients were observed through electron microscopy. RESULTS There were a lot of histocytes and multinuclear giant cells in the lesions. A great quantity of lysosome like structure was observed in multinuclear giant cells and histocytes. A part of lysosome like structure was supposed as bacteria. Besides coccus, a kind of anaerobic actinomycetes was isolated with anaerobic culture according to the finding of electron microscopy. The patient was saved on the base of the result of medicine sensitive test of bacteria. CONCLUSION It is the most convinced proof to find pathogen on electron microscopy for the diseases suspected due to pathogens. The electron microscopy plays a key role in the finding and naming of the disease.