Buruli ulcer - Revision history

ClaireLewis at 04:21, 28 December 2020

2020-12-28T04:21:55Z

← Older revision		Revision as of 04:21, 28 December 2020
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	*Antibiotic therapy		*Antibiotic therapy
	**Guided by severity of lesions		**Guided by severity of lesions
	**Most commonly 8 weeks of rifampin and clarithromycin <ref> O'Brien DP, Jenkin G, Buntine J, et al. Treatment and prevention of Mycobacterium ulcerans infection (Buruli ulcer) in Australia: guideline update. Med J Aust. 2014;200(5):267-270. doi:10.5694/mja13.11331</ref>		**Most commonly 8 weeks of [[rifampin]] and [[clarithromycin]] <ref> O'Brien DP, Jenkin G, Buntine J, et al. Treatment and prevention of Mycobacterium ulcerans infection (Buruli ulcer) in Australia: guideline update. Med J Aust. 2014;200(5):267-270. doi:10.5694/mja13.11331</ref>
	*Most cases will heal with antibiotics alone, but healing is often incomplete until after antibiotic therapy		*Most cases will heal with antibiotics alone, but healing is often incomplete until after antibiotic therapy
	*Surgical debridement can be considered to remove necrotic tissue		*Surgical debridement can be considered to remove necrotic tissue
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	==References==		==References==
	<references/>		<references/>
			[[Category:ID]]

Rossdonaldson1: /* Laboratory Testing */

2020-12-12T13:28:01Z

Laboratory Testing

← Older revision		Revision as of 13:28, 12 December 2020
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	*There are several options for laboratory evaluation, but in endemic regions diagnosis is often made by clinical diagnosis due to limited resources		*There are several options for laboratory evaluation, but in endemic regions diagnosis is often made by clinical diagnosis due to limited resources

	===Laboratory Testing~~===~~		===Laboratory Testing<ref> Phillips R, Horsfield C, Kuijper S, et al. Sensitivity of PCR targeting the IS2404 insertion sequence of Mycobacterium ulcerans in an Assay using punch biopsy specimens for diagnosis of Buruli ulcer. J Clin Microbiol. 2005;43(8):3650-3656. doi:10.1128/JCM.43.8.3650-3656.2005
	<ref> Phillips R, Horsfield C, Kuijper S, et al. Sensitivity of PCR targeting the IS2404 insertion sequence of Mycobacterium ulcerans in an Assay using punch biopsy specimens for diagnosis of Buruli ulcer. J Clin Microbiol. 2005;43(8):3650-3656. doi:10.1128/JCM.43.8.3650-3656.2005		</ref> <ref> Phillips RO, Sarfo FS, Osei-Sarpong F, et al. Sensitivity of PCR targeting Mycobacterium ulcerans by use of fine-needle aspirates for diagnosis of Buruli ulcer. J Clin Microbiol. 2009;47(4):924-926. doi:10.1128/JCM.01842-08 </ref>===
	</ref> <ref> Phillips RO, Sarfo FS, Osei-Sarpong F, et al. Sensitivity of PCR targeting Mycobacterium ulcerans by use of fine-needle aspirates for diagnosis of Buruli ulcer. J Clin Microbiol. 2009;47(4):924-926. doi:10.1128/JCM.01842-08 </ref>
	*Acid fast staining – does not rule out other related infections such as mycobacterium tuberculosis, sensitivity is approximately 40%		*Acid fast staining – does not rule out other related infections such as mycobacterium tuberculosis, sensitivity is approximately 40%
	*Culture – mycobacterium ulcerans grows slowly in laboratory (positive results require 6 weeks or more), sensitivity is approximately 60%		*Culture – mycobacterium ulcerans grows slowly in laboratory (positive results require 6 weeks or more), sensitivity is approximately 60%
	*Histology – sensitivity up to 82%		*Histology – sensitivity up to 82%
	*PCR – sensitivity 70-80%		*PCR – sensitivity 70-80%

	==Management==		==Management==

Rossdonaldson1: /* Tropical ulcers */

2020-12-12T12:19:50Z

Tropical ulcers

← Older revision		Revision as of 12:19, 12 December 2020
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	*Diabetic skin ulceration		*Diabetic skin ulceration
	*Squamous cell carcinoma		*Squamous cell carcinoma

	~~===Tropical ulcers===~~
	*Cutaneous [[leishmaniasis]]
	*[[Buruli ulcer]]
	*[[Dracunculiasis]] (Guinea Worm disease)

	{{Travel Skin Conditions DDX}}		{{Travel Skin Conditions DDX}}

Rossdonaldson1: /* Differential Diagnosis */

2020-12-12T12:19:35Z

Differential Diagnosis

← Older revision		Revision as of 12:19, 12 December 2020
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	*[[Buruli ulcer]]		*[[Buruli ulcer]]
	*[[Dracunculiasis]] (Guinea Worm disease)		*[[Dracunculiasis]] (Guinea Worm disease)

			{{Travel Skin Conditions DDX}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Differential Diagnosis */

2020-12-12T12:18:23Z

Differential Diagnosis

← Older revision		Revision as of 12:18, 12 December 2020
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Tropical ulcer
	*Cutaneous [[leishmaniasis]]
	*[[Eumycetoma]]		*[[Eumycetoma]]
	*[[Pyoderma gangrenosum]]		*[[Pyoderma gangrenosum]]
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	*Diabetic skin ulceration		*Diabetic skin ulceration
	*Squamous cell carcinoma		*Squamous cell carcinoma

			===Tropical ulcers===
			*Cutaneous [[leishmaniasis]]
			*[[Buruli ulcer]]
			*[[Dracunculiasis]] (Guinea Worm disease)

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Background */

2020-12-12T12:08:20Z

Background

← Older revision		Revision as of 12:08, 12 December 2020
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	==Background==		==Background==
			[[File:Buruli ulcer cases 2018 colors.png\|thumb\|Cases of Buruli ulcer reported to the World Health Organization in 2018. Color indicates case number: yellow, (1–150) Dem. Rep. Congo, Gabon, Guinea, Togo; orange (151–300), Benin, Cameroon, Côte d'Ivoire; light red (301–450), Liberia, Nigeria; dark red (451+), Ghana. Not shown are Australia (358), Papua New Guinea (12) and Japan (3).]]
	*Skin infection caused by Mycobacterium ulcerans		*Skin infection caused by Mycobacterium ulcerans
	*Named for Buruli district in Uganda		*Named for Buruli district in Uganda

Rossdonaldson1: /* Clinical Features */

2020-12-12T12:05:19Z

Clinical Features

← Older revision		Revision as of 12:05, 12 December 2020
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	==Clinical Features==		==Clinical Features==
	[[File:Buruli ulcers grouped image.png\|thumb\|~~Buruli~~ ulcer ~~lesions. Top-left, an~~ early ulcer~~. Top~~-~~right, a~~ larger ulcer across the lower arm and wrist~~. Bottom~~, a large ulcer on the thigh.]]		[[File:Early signs of BU.png\|thumb\|Early signs of Buruli ulcer: painless swollen bumps (top); plaque (bottom-left); and widespread swelling of the lower arm (bottom-right).]]
			[[File:Buruli ulcers grouped image.png\|thumb\|Later signs of a buruli ulcer: early ulcer (top-left); larger ulcer across the lower arm and wrist (top-right), and a large ulcer on the thigh (bottom).]]
	*Usually begins as a painless nodule <5cm in diameter, but also may initially present as papules, plaques, or edematous lesions		*Usually begins as a painless nodule <5cm in diameter, but also may initially present as papules, plaques, or edematous lesions
	*Limbs are most frequently involved, although it may also affect the head, neck, trunk, and genitals		*Limbs are most frequently involved, although it may also affect the head, neck, trunk, and genitals

Rossdonaldson1: /* Clinical Features */

2020-12-12T11:52:17Z

Clinical Features

← Older revision		Revision as of 11:52, 12 December 2020
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	==Clinical Features==		==Clinical Features==
			[[File:Buruli ulcers grouped image.png\|thumb\|Buruli ulcer lesions. Top-left, an early ulcer. Top-right, a larger ulcer across the lower arm and wrist. Bottom, a large ulcer on the thigh.]]
	*Usually begins as a painless nodule <5cm in diameter, but also may initially present as papules, plaques, or edematous lesions		*Usually begins as a painless nodule <5cm in diameter, but also may initially present as papules, plaques, or edematous lesions
	*Limbs are most frequently involved, although it may also affect the head, neck, trunk, and genitals		*Limbs are most frequently involved, although it may also affect the head, neck, trunk, and genitals

Rossdonaldson1: Rossdonaldson1 moved page Buruli Ulcer to Buruli ulcer

2020-12-12T11:50:33Z

Rossdonaldson1 moved page Buruli Ulcer to Buruli ulcer

← Older revision	Revision as of 11:50, 12 December 2020
(No difference)

SeanDenny: /* Differential Diagnosis */

2020-12-10T00:30:37Z

Differential Diagnosis

← Older revision		Revision as of 00:30, 10 December 2020
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	==Differential Diagnosis==		==Differential Diagnosis==
	*Tropical ulcer		*Tropical ulcer
	*Cutaneous leishmaniasis		*Cutaneous [[leishmaniasis]]
	*Eumycetoma		*[[Eumycetoma]]
	*Pyoderma gangrenosum		*[[Pyoderma gangrenosum]]
	*Venous stasis ulcer		*Venous stasis ulcer
	*Diabetic skin ulceration		*Diabetic skin ulceration
	*Squamous cell carcinoma		*Squamous cell carcinoma


	==Evaluation==		==Evaluation==