Because of the emergence of Buruli ulcer disease, theWorld Health Organization launched a Global Buruli UlcerInitiative in 1998. This indolent skin infection is caused byMycobacterium ulcerans. During a study of risk factors forthe disease in Ghana, adequate excisional skin-biopsyspecimens were obtained from 124 clinically suspiciouslesions. Buruli ulcer disease was diagnosed in 78 lesionssince acid-fast bacilli (AFB) were found by histopathologicexamination. Lesions with other diagnoses included filaria-sis (3 cases), zygomycosis (2 cases), ulcerative squamouscell carcinomas (2 cases), keratin cyst (1 case), and lymphnode (1 case). Thirty-seven specimens that did not showAFB were considered suspected Buruli ulcer diseasecases. Necrosis of subcutaneous tissues and dermal colla-gen were found more frequently in AFB-positive specimenscompared with specimens from suspected case-patients(p<0.001). Defining histologic criteria for a diagnosis ofBuruli ulcer disease is of clinical and public health impor-tance since it would allow earlier treatment, leading to lessdeforming sequelae
展开▼
