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M ycobacterium ulcerans infection: evolution in clinical management
Author(s) -
Simpson Candice,
O'Brien Daniel P.,
McDonald Anthony,
Callan Peter
Publication year - 2012
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2012.06230.x
Subject(s) - medicine , mycobacterium ulcerans , debridement (dental) , buruli ulcer , deformity , surgery , antibiotics , skin grafting , dermatology , disease , microbiology and biotechnology , biology
Abstract M ycobacterium ulcerans causes significant morbidity in various endemic locations in A ustralia and W est A frica. The commonest presentation is as a necrotic ulcer often with surrounding subcutaneous necrosis and oedema, which can cause significant morbidity, deformity and functional impairment. Traditional treatment was wide excision and debridement with grafting or flap reconstructions further adding to morbidity and with high recurrence rates. Following publication of clinical studies where antibiotics were shown to be effective, treatment has moved towards combination management with systemic antibiotics and limited surgery involving mainly debridement of the ulcers. Identification of the ‘paradoxical’ immune‐reconstitution syndrome has also impacted upon the extent of excision required. This paper will present the evolution in clinical management of M . ulcerans cases on the B ellarine P eninsula, V ictoria, A ustralia.