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Mycobacterium ulcerans infection in a child from Angola: diagnosis by direct detection and culture
W Bär1, S Rüsch-Gerdes, E Richter
1Carl-Thiem-Klinikum, Cottbus, Germany.
Insights
This case report details the first documented instance of Buruli ulcer in Angola, a severe skin disease caused by Mycobacterium ulcerans. The successful treatment of a young boy highlights effective therapeutic strategies for this neglected tropical disease.
Area of Science:
- Infectious Diseases
- Dermatology
- Tropical Medicine
Background:
- Buruli ulcer is a chronic ulcerative skin disease caused by Mycobacterium ulcerans.
- It is endemic in tropical and subtropical regions, primarily in West Africa and Australia.
- Early diagnosis and treatment are crucial to prevent severe morbidity.
Observation:
- A 2.5-year-old boy from Angola presented with severe kwashiorkor and a large, undermined ulcer on his thorax.
- Clinical examination revealed anemia, hypoproteinemia, secondary bacterial infection, and intestinal parasites.
- Histopathology confirmed Mycobacterium ulcerans, consistent with Buruli ulcer.
Findings:
- Mycobacterium ulcerans was identified via PCR and culture.
- The patient underwent surgical excision of the ulcer and split-skin grafting.
- Antibiotic therapy included ciprofloxacin, clarithromycin, rifabutin, and dapsone.
Implications:
- This is the first reported case of Buruli ulcer in Angola, expanding the known geographical distribution.
- Successful management underscores the efficacy of combined surgical and antibiotic treatment.
- Highlights the need for increased awareness and diagnostic capabilities for Buruli ulcer in Angola and surrounding regions.
Abstract:
Buruli ulcer, caused by Mycobacterium ulcerans, is a chronic ulcerative skin disease, found predominantly in central and west Africa and Australia. A boy of 2.5 years of age from Angola was admitted to our hospital with severe kwashiokor and a large ulcer with undermined edges on the left side of the thorax. Further examination revealed anaemia, hypoproteinaemia, bacterial superinfection of the ulcer and intestinal parasites. Histological analysis showed acid-fast bacilli and histopathological changes typical of Buruli ulcer. M. ulcerans was detected by PCR and culture. The patient was treated by surgical excision of diseased skin, followed by split-skin grafting. He also received antibiotic therapy (ciprofloxacin, clarithromycin, rifabutin, and dapsone). After six months, the child was discharged from hospital in good condition. This is the first published case of Buruli ulcer from Angola.