Asunto(s)
Síndrome del Túnel Carpiano/epidemiología , Enfermedades Profesionales/epidemiología , Síndrome del Túnel Carpiano/economía , Femenino , Humanos , Incidencia , Masculino , Enfermedades Profesionales/economía , Ocupaciones/estadística & datos numéricos , Victoria , Indemnización para TrabajadoresRESUMEN
Mycobacterium ulcerans is a slow-growing environmental bacterium that causes Buruli ulcer (also known as Bairnsdale ulcer in Victoria and Daintree ulcer in northern Queensland). We describe two patients with laboratory-confirmed Buruli ulcer who were infected either in New South Wales or overseas. A molecular epidemiological investigation demonstrated that, while one case was probably acquired in Papua New Guinea, the other was most likely to have been acquired in southern NSW. To our knowledge, this is the first case of M. ulcerans infection acquired in NSW.
Asunto(s)
Infecciones por Mycobacterium no Tuberculosas/etiología , Mycobacterium ulcerans/aislamiento & purificación , Úlcera Cutánea/etiología , Adulto , Microbiología Ambiental , Humanos , Masculino , Persona de Mediana Edad , Mycobacterium ulcerans/genética , Papúa Nueva Guinea , Enfermedades Cutáneas Bacterianas/etiología , Úlcera Cutánea/microbiología , Secuencias Repetidas en TándemRESUMEN
Mycobacterium ulcerans causes slowly progressive, destructive skin and soft tissue infections, known as Bairnsdale or Buruli ulcer (BU). Forty-six delegates with experience in the management of BU attended a 1-day conference in Melbourne on 10 February 2006, with the aim of developing a consensus approach to the diagnosis, treatment and control of BU. An initial draft document was extended and improved during a facilitated round table discussion. BU is an environmental infection that occurs in specific locations. The main risk factor for infection is contact with an endemic area. Prompt cleaning of abrasions sustained outdoors, wearing protective clothing, and avoiding mosquito bites may reduce an individual's risk of infection. BU can be rapidly and accurately diagnosed by polymerase chain reaction testing of ulcer swabs or biopsies. Best outcomes are obtained when the diagnosis is made early. To aid early diagnosis, health authorities should keep local populations informed of new outbreaks. BU is best treated with surgical excision, which, if possible, should include a small rim of healthy tissue. For small lesions this may be all that is required. However, there is a role for antibiotics for more extensive disease, and their use may allow more conservative surgery.