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Paediatric Buruli ulcer in Australia

Georgia Walker1, Deborah N Friedman2, Matthew P O'Brien3

  • 1Department of Paediatrics, Barwon Health, Geelong, Victoria, Australia.

Journal of Paediatrics and Child Health
|December 11, 2019
PubMed

Insights

Paediatric Buruli ulcer (BU) cases are rising in Australia. Children with BU present differently and have distinct treatment outcomes compared to adults, with higher rates of severe lesions but fewer antibiotic complications.

Area of Science:

  • Infectious Diseases
  • Paediatric Medicine
  • Dermatology

Background:

  • Buruli ulcer (BU) is a chronic mycobacterial infection primarily affecting tropical and subtropical regions.
  • While predominantly seen in adults, paediatric cases of BU are increasingly reported globally and in Australia.

Purpose of the Study:

  • To describe the characteristics of paediatric Buruli ulcer (BU) patients in an Australian cohort.
  • To compare the clinical presentation, treatment, and outcomes of paediatric BU cases with adult BU patients.

Main Methods:

  • Prospective cohort analysis of all BU cases managed at Barwon Health, Victoria, Australia, from January 1998 to May 2018.
  • Patients were categorized into children (≤15 years) and adults (16-64 years and ≥65 years).
  • Comparison of lesion types, severity, symptom duration, treatment complications, and cure rates between paediatric and adult cohorts.

Main Results:

  • The cohort included 52 paediatric BU patients (9.2%) and 513 adult patients.
  • Children exhibited a higher proportion of non-ulcerative (32.7%) and severe lesions (26.9%) compared to adults.
  • Paediatric patients had shorter symptom duration before diagnosis and lower rates of antibiotic complications but higher rates of paradoxical reactions.
  • High cure rates were observed in both children and adults treated with antibiotics alone or with antibiotics and surgery.

Conclusions:

  • Paediatric BU cases are increasing in Australia, forming a significant proportion of the overall BU burden.
  • Distinct differences in clinical presentation and treatment outcomes exist between paediatric and adult BU patients in Australia.
  • This highlights the need for tailored management strategies for children with Buruli ulcer.
Abstract

Keywords:
AustraliaBuruli ulcerpaediatricsparadoxical reaction

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