Buruli ulcer What you call boil may be Buruli ulcer Continued .... Symptoms According to the World Health Organisation, “Buruli ulcer often starts as a painless swelling (nodule). It can initially also present as a large painless area of induration (hardening of a normally soft tissue or organ, especially the skin, because of inflammation or an accumulation of blood) or a diffuse painless swelling of the leg...s, arms or face (oedema). “Local immunosuppressive properties of the mycolactone toxin enable the disease to progress with no pain and fever. Without treatment or, sometimes during antibiotics treatment, the nodule, plaque or oedema will ulcerate within four weeks with the classical, undermined borders. Occasionally, bone is affected, causing gross deformities.” Diagnosis Experts warn that because research is still ongoing about how to correctly diagnose this painful disease, early nodular lesions are occasionally confused with boils, lipomas (a benign tumor composed of body fat), ganglions (lumps that shows up next to a joint or a tendon), lymph node tuberculosis, onchocerciasis nodules or other subcutaneous infections such as fungal infection. “In some cases, papular lesions may initially be confused with an insect bite. Worse still, it may be confused with cellulitis — another potentially serious skin infection,” physicians warn. Those at risk While the route of transmission remains unclear, authorities at Centres for Disease Control and Prevention say one hypothesis is that M. ulcerans enters the body through a break in the skin, via insect bite, cut or wound. Experts say those who risk having Buruli ulcer include children, aged people and those who live in rural areas where strict hygiene is not adhered to. The WHO experts also report that domestic animals such cat, horse, and dog have been diagnosed as having this disease. “Also at risk are those whose immune system has been weakened as a result of infectious diseases such as HIV/AIDS, making the progress of Buruli ulcer more aggressive in such persons,” Obiajunwa says. Indeed, physicians warn that patients who have a combination of Buruli ulcer and HIV often present lesions (damage) in multiple areas of the body, as well as bone infection (osteomyelitis). Consequently, patients infected with a combo of Buruli ulcer and HIV are advised to also undergo screening for tuberculosis. Control & treatment Experts say at present, there’s no vaccine for the primary prevention of Buruli ulcer, but that once diagnosed, patients could be treated with different combinations of antibiotics over an eight-week period. The WHO also recommends complementary treatment such as wound care, surgery (mainly debridement and skin grafting) and interventions to minimise or prevent disabilities, depending on the stage of the disease. Experts also stress the need for health education at the community level to enhance early reporting; training of health workers and village volunteers; laboratory confirmation of cases; strengthening of health facilities; and monitoring and evaluation of control activities in order to wipe out Buruli ulcer.
Posted on: Mon, 01 Jul 2013 12:47:51 +0000
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