Edematous Mycobacterium ulcerans Infection (Buruli Ulcer) on the Face: A Case Report

Delphin M. Phanzu Institut Médical Evangélique, Kimpese, Bas-Congo, Democratic Republic of Congo; Noguchi Memorial Institute for Medical Research, Legon, Ghana; Onze Lieve Vrouw Hospital, Aalst, Belgium; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium; Armed Forces Institute of Pathology, Washington, District of Columbia

Search for other papers by Delphin M. Phanzu in
Current site
Google Scholar
PubMed
Close
,
Anthony Ablordey Institut Médical Evangélique, Kimpese, Bas-Congo, Democratic Republic of Congo; Noguchi Memorial Institute for Medical Research, Legon, Ghana; Onze Lieve Vrouw Hospital, Aalst, Belgium; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium; Armed Forces Institute of Pathology, Washington, District of Columbia

Search for other papers by Anthony Ablordey in
Current site
Google Scholar
PubMed
Close
,
Desire B. Imposo Institut Médical Evangélique, Kimpese, Bas-Congo, Democratic Republic of Congo; Noguchi Memorial Institute for Medical Research, Legon, Ghana; Onze Lieve Vrouw Hospital, Aalst, Belgium; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium; Armed Forces Institute of Pathology, Washington, District of Columbia

Search for other papers by Desire B. Imposo in
Current site
Google Scholar
PubMed
Close
,
Lucien Lefevre Institut Médical Evangélique, Kimpese, Bas-Congo, Democratic Republic of Congo; Noguchi Memorial Institute for Medical Research, Legon, Ghana; Onze Lieve Vrouw Hospital, Aalst, Belgium; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium; Armed Forces Institute of Pathology, Washington, District of Columbia

Search for other papers by Lucien Lefevre in
Current site
Google Scholar
PubMed
Close
,
Roger L. Mahema Institut Médical Evangélique, Kimpese, Bas-Congo, Democratic Republic of Congo; Noguchi Memorial Institute for Medical Research, Legon, Ghana; Onze Lieve Vrouw Hospital, Aalst, Belgium; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium; Armed Forces Institute of Pathology, Washington, District of Columbia

Search for other papers by Roger L. Mahema in
Current site
Google Scholar
PubMed
Close
,
Patrick Suykerbuyk Institut Médical Evangélique, Kimpese, Bas-Congo, Democratic Republic of Congo; Noguchi Memorial Institute for Medical Research, Legon, Ghana; Onze Lieve Vrouw Hospital, Aalst, Belgium; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium; Armed Forces Institute of Pathology, Washington, District of Columbia

Search for other papers by Patrick Suykerbuyk in
Current site
Google Scholar
PubMed
Close
,
Wayne M. Meyers Institut Médical Evangélique, Kimpese, Bas-Congo, Democratic Republic of Congo; Noguchi Memorial Institute for Medical Research, Legon, Ghana; Onze Lieve Vrouw Hospital, Aalst, Belgium; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium; Armed Forces Institute of Pathology, Washington, District of Columbia

Search for other papers by Wayne M. Meyers in
Current site
Google Scholar
PubMed
Close
, and
Françoise Portaels Institut Médical Evangélique, Kimpese, Bas-Congo, Democratic Republic of Congo; Noguchi Memorial Institute for Medical Research, Legon, Ghana; Onze Lieve Vrouw Hospital, Aalst, Belgium; Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium; Armed Forces Institute of Pathology, Washington, District of Columbia

Search for other papers by Françoise Portaels in
Current site
Google Scholar
PubMed
Close
Restricted access

We report a case of a four-year-old Angolan boy with the edematous form of Buruli ulcer on the face and scalp, who was treated at a rural hospital in the Bas-Congo Province, Democratic Republic of Congo. Treatment consisted of a series of surgical interventions and antimycobacterial chemotherapy (rifampin and ciprofloxacin) for two months. This case demonstrates the diagnostic and management difficulties of an edematous lesion of BU on the face and suggests an enhancement of healing and limitation of extent of excision by specific antibiotherapy. The outcome in this patient also underscores the importance of prompt referral of suspected cases and training of health professionals in the early diagnosis of BU.

Author Notes

  • 1

    World Health Organization, 2001. Buruli ulcer. Diagnosis of Mycobacterium ulcerans disease. Portaels F, Johnson P, Meyers WM, eds. Geneva: World Health Organization. WHO/CDS/ CPE/GBUI/2001.4.

    • PubMed
    • Export Citation
  • 2

    World Health Organization, 2004. Buruli ulcer disease. Mycobacterium ulcerans infection: an overview of reported cases globally. Wkly Epidemiol Rec 79 :194–200.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Janssens P, Pattyn S, Meyers WM, Portaels F, 2005. Buruli ulcer: a historical overview with updating to 2005. Bull Séances Acad R Sci Outre Mer 51 :265–299.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    World Health Organization, 2000. Buruli ulcer–Mycobacterium ulcerans Infection. Asiedu K, Sherpbier R, Raviglione M, eds. Geneva: World Health Organization. WHO/CDS/CPE/GBUI/ 2001.1.

    • PubMed
    • Export Citation
  • 5

    Etuaful S, Carbonnelle B, Grosset J, Lucas S, Horsfield C, Phillips R, Evans M, Ofori-Adjei D, Klustse E, Owusu-Boateng J, Amedofu GK, Awuah P, Ampadu E, Amofah G, Asiedu K, Wansbrough-Jones M, 2005. Efficacy of the combination rifampin-streptomycin in preventing growth of Mycobacterium ulcerans in early lesions of Buruli ulcer in humans. Antimicrob Agents Chemother 49 :3182–3186.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Sizaire V, Nackers F, Comte E, Portaels F, 2006. Mycobacterium ulcerans infection: control, diagnosis, and treatment. Lancet Infect Dis 6 :288–296.

  • 7

    Phanzu DM, Bafende AE, Dunda BK, Imposo DB, Kibadi KA, Nsiangana ZS, Singa NJ, Meyers WM, Suykerbuyk P, Portaels F, 2006. Mycobacterium ulcerans disease (Buruli ulcer) in a rural hospital in Bas-Congo, Democratic Republic of Congo, 2002–2004. Am J Trop Med Hyg 75 :311–314.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Bafende AE, Phanzu MD, Imposo DB, 2004. Buruli ulcer in the Democratic Republic of Congo: epidemiology, presentation and outcome. Trop Doct 34 :82–84.

  • 9

    Meyers WM, Connor DH, McCullough B, Bourland J, Moris R, Proos L, 1974. Distribution of Mycobacterium ulcerans infection in Zaïre, including the report of new foci. Ann Soc Belg Med Trop 54 :147–157.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Kibadi K, Tsakala TM, Mputu-Yamba JB, Muyembe T, Kashongwe M, Imposo B, Nsiala A, 2003. L’ulcère de Buruli chez les réfugiés Angolais des sites de Kimpese, Bas-Congo. Cahiers Santé 13 :39–41.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Portaels F, 1989. Epidémiologie des ulcères à Mycobacterium ulcerans. Ann Soc Belg Med Trop 69 :91–103.

  • 12

    Kibadi K, 2004. Enquête connaissances-attitudes-pratiques (CAP) de la population de Songololo (RD Congo) sur l’ulcère de Buruli. Bull Soc Pathol Exot 97 :302–305.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    Johnson RC, Makoudote M, Hougnihin R, Guédénon A, Ifebe D, Boko M, Portaels F, 2004. Le traitement traditionnel de l’ulcère de Buruli au Bénin. Med Trop (Mars) 64 :145–150.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14

    Kibadi K, Aujoulat I, Meyers WM, Mokassa L, Muyembe T, Portaels F, 2007. Etude des appellations et des représentations attachées à l’infection à Mycobacterium ulcerans dans les différents pays endémiques d’Afrique. Med Trop 67 :241–248.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Portaels F, Silva MT, Meyers WM, 2008. Buruli ulcer. Clin Dermatol (in press).

  • 16

    World Health Organization, 2004. Provisional Guidance on the Role of Specific Antibiotics in the Management of Mycobacterium ulcerans Disease (Buruli ulcer). Geneva: World Health Organization. WHO/CDS/CPE/GBUI/2004.10.

    • PubMed
    • Export Citation
  • 17

    Meyers WM, 1995. Mycobacterial infections of the skin. Doerr W, Seifert G, eds. Tropical Pathology. Second edition. Berlin: Springer-Verlag, 291–377.

    • PubMed
    • Export Citation
  • 18

    Debacker M, Aguiar J, Steunou C, Zinsou C, Meyers WM, Guédénon A, Scott JT, Dramaix M, Portaels F, 2004. Mycobacterium ulcerans disease (Buruli ulcer) in a rural hospital, southern Benin, 1997–2001. Emerg Infect Dis 10 :1391–1398.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Debacker M, Aguiar J, Steunou C, Zinsou MD, Meyers WM, Scott JT, Dramaix M, Portaels F, 2004. Mycobacterium ulcerans disease: role of age and gender in incidence and morbidity. Trop Med Int Health 9 :1297–1304.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 222 189 18
Full Text Views 84 1 0
PDF Downloads 21 1 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save