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Am. J. Trop. Med. Hyg., 77(6), 2007, pp. 1099-1102
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


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

Delphin M. Phanzu, Anthony Ablordey, Desire B. Imposo, Lucien Lefevre, Roger L. Mahema, Patrick Suykerbuyk, Wayne M. Meyers, 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

 

ABSTRACT

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.

Received June 27, 2007. Accepted for publication August 31, 2007.

Acknowledgments: We thank the staff of the Institut Médical Evangélique in Kimpese staff and the staff of the Mycobacteriology Unit of the Institute of Tropical Medicine in Antwerp for patient care and microbiologic analyses. We also thank Gaëlle Antoine for an outstanding work in preparation of the manuscript.

Financial support: This study was supported by the European Commission (International Science and Technology Cooperation Development Program), Project No. INCO-CT-2005-05-051476-BURULICO.

* Address correspondence to Françoise Portaels, Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Nationalstraat 155, Antwerp 2000, Belgium. E-mail: portaels{at}itg.be

Authors’ addresses: Delphin M. Phanzu, Desire B. Imposo, and Roger L. Mahema, Institut Médical Evangélique, PO Box 68, Kimpese, Bas-Congo, Democratic Republic of Congo. Anthony Ablordey, Noguchi Memorial Institute for Medical Research, PO Box 25, Legon, Ghana. Lucien Lefevre, Onze Lieve Vrouw Hospital, Moorselbaan 64, Aalst, Belgium. Patrick Suykerbuyk and Françoise Portaels, Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium. Wayne M. Meyers, Armed Forces Institute of Pathology, Washington, DC 20306.






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