[Bifocal Buruli ulcer: multiple cephalic lesions after initiation of medical treatment]. / Ulcère de Buruli à début bifocal: multiples lésions céphaliques après instauration du traitement médical.
Ann Dermatol Venereol
; 140(2): 125-8, 2013 Feb.
Article
en Fr
| MEDLINE
| ID: mdl-23395495
ABSTRACT
BACKGROUND:
Buruli ulcer (BU) denotes a cutaneous infection by Mycobacterium ulcerans endemic in certain tropical and subtropical regions. Treatment may be either medical and surgical or else purely medical for early lesions. The literature contains reports of several cases of transient aggravation of BU following initiation of medical treatment. We report a case observed in the Ivory Coast, one of the areas with the highest prevalence of BU worldwide. The distinguishing features of our case are the early onset of this paradoxical reaction and the multiple cephalic site of lesions. PATIENTS ANDMETHODS:
A 4-year-old child with no prior medical history was referred for two painless ulcerative cutaneous nodules. Incubation of samples from the edges of these lesions revealed the presence of acid-alcohol resistant bacilli (AARB), which were shown by PCR to be M. ulcerans, the causative agent in BU. Treatment consisted of levofloxacin (100mg/d) and rifampicin (150mg/d) for 8weeks. After 7days of medical treatment, seven painless nodules appeared on the patient's scalp. Further PCR for these lesions confirmed the presence of M. ulcerans. The same medical therapy was maintained and after 54days of treatment, all lesions had been healed.DISCUSSION:
The originality of this case rests on two features the bifocal aspect of the lesions, which is uncommon, and the early development of cephalic predominance that occurred after the start of drug treatment. While cases of lesions secondary to initiation of medical therapy have already been described, such lesions generally occurred after at least 2months of treatment and did not involve the head.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Rifampin
/
Dermatosis del Cuero Cabelludo
/
Ofloxacino
/
Úlcera de Buruli
/
Levofloxacino
/
Antibacterianos
Tipo de estudio:
Etiology_studies
/
Risk_factors_studies
Límite:
Child, preschool
/
Female
/
Humans
País/Región como asunto:
Africa
Idioma:
Fr
Revista:
Ann Dermatol Venereol
Año:
2013
Tipo del documento:
Article