[Paradoxical reactions and responses during antibiotic treatment for Mycobacterium ulcerans infection (Buruli ulcer). Four cases from French Guiana]. / Réponses et réactions paradoxales au cours du traitement médicamenteux de l'infection à Mycobacterium ulcerans (ulcère de Buruli). Quatre observations en Guyane française.
Ann Dermatol Venereol
; 141(6-7): 413-8, 2014.
Article
en Fr
| MEDLINE
| ID: mdl-24951139
ABSTRACT
BACKGROUND:
In recent years, first-line therapy for Mycobacterium ulcerans infection in French Guiana has consisted of antibiotics active against this organism. Two regimens are used comprising rifampicin associated with clarithromycin or amikacin. PATIENTS ANDMETHODS:
We describe four patients presenting apparent worsening of their lesions during treatment ulceration of a nodular lesion in a 32-year-old woman and worsening of an ulcerated lesion in three patients aged 16, 27 and 79 years.DISCUSSION:
In these 4 patients, we concluded that the symptoms were caused by a paradoxical response or a reaction, a phenomenon already described in tuberculosis and leprosy. Such worsening is transient and must not be misinterpreted as failure to respond to treatment. The most plausible pathophysiological hypothesis involves the re-emergence of potentially necrotizing cellular immunity secondary to the loss of mycolactone, a necrotizing and immunosuppressive toxin produced by M. ulcerans, resulting from the action of the antibiotics.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Rifampin
/
Amicacina
/
Claritromicina
/
Úlcera de Buruli
/
Antibacterianos
Tipo de estudio:
Etiology_studies
/
Qualitative_research
País/Región como asunto:
America do sul
/
Asia
/
Brasil
/
Caribe ingles
/
Europa
/
Guyana
/
Guyana francesa
Idioma:
Fr
Revista:
Ann Dermatol Venereol
Año:
2014
Tipo del documento:
Article