A Severe Case of Buruli Ulcer Disease with Pleural Effusions

Thompson, W. A.; Phillips, Richard Odame; Paintsil, Albert; Abass, Mohammed K.; Frimpong, Michael; Abotsi, Justice; Asiedu, Kingsley; Wansbrough‐Jones, Mark

doi:10.1371/journal.pntd.0002868

Cited by 1 publication

(1 citation statement)

References 8 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This immunological reaction is thought to be due to an exuberant reconstitution of the local immune response during the demise of MU bacilli under the influence of antibiotic therapy and mediated by immune-stimulators released from dying MU in areas of declining mycolactone concentration. And histologically, it is characterized by massive leucocytes infiltration of necrotic areas in surgically excised sample contrary to the acellular or scanty immune cell infiltrates observed in untreated MU infected skin lesions [20,21] . To treat these paradoxical reactions, oral cortostroïds were used to minimize damage from severe reactions [22,23] .…”

Section: Introductionmentioning

confidence: 99%

Management of HIV Infected Patients with Active Buruli Ulcer in Tropical Regions in Africa, a New Therapeutic Challenge: A Review

Kassi¹,

Serge²,

Jean-Marie³

2016

Journal of Dermatological Research

View full text Add to dashboard Cite

BU is endemic in tropical and sub-tropical regions mainly with high prevalence in sub-Saharan Africa, in particular in West Africa. SubSaharan Africa is also burdened with high HIV prevalence. Therefore, there is a significant potential for BU and HIV to occur in the same individual, and it represented a treatment challenge related to paradoxical reactions or IRIS onset. A study conducted in Cameroon reported that the mortality rate was higher among HIV-positive/BU patients compared to HIV-negative /BU patients (11% dying compared to 1%). We conducted this work based on review articles on HIV/BU co-infection to summarize information and guidance data to help health care practitioners for proper patients' management. It is becoming obvious that HIV infection have an effect on BU incidence mainly in Sub-Saharan Africa and its clinical presentation and treatment similar to tuberculosis. Based on TB/HIV and HIV/others microorganism s management experience and WHO expert in HIV and BU management guidance protocol, it is recommended to health practitioner. To actively screen all HIV/MU co-infected patients for tuberculosis, before commencing BU treatment and before starting ART. To start BU treatment before commencing ART and it should be provided for 8 weeks duration. The outcomes of HIV/BU coinfection management should be monitored and evaluated, taking account the drugs interactions between ART and antimicrobial agents. And the program for HIV, BU and TB control should work in a collaborative framework. As, HIV/BU co-infection becomes frequent in Sub-Saharan Africa where both disease incidence is high. This represents a treatment challenge related to IRIS occurrence, optimal ART regimens, and when to start ART and antimicrobial treatment. Base on TB/HIV co-infection, the preliminary guidance protocol issue by WHO should be recommended, and further study should be initiated to show its efficacy and to give answers to unknown mechanism of IRIS in HIV/BU co-infection.

show abstract

Section: Introductionmentioning

confidence: 99%