Mycobacterium ulcerans infection in North Queensland: the ‘Daintree ulcer’

Steffen, Christina M.; Smith, May; McBride, William J. H.

doi:10.1111/j.1445-2197.2010.05338.x

Cited by 40 publications

(44 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Victoria, cases have been reported in Gippsland, Phillip Island [6] and the Mornington [7] and Bellarine Peninsulas [8] [9] [10]. In Queensland there is a significant established focus in Far North Queensland [11] [12]. Sporadic cases have been reported in the Northern Territory (NT) [13] and Capricorn Coast of southern Queensland [14].…”

Section: Introductionmentioning

confidence: 99%

The Incubation Period of Buruli Ulcer (Mycobacterium ulcerans Infection)

et al. 2013

View full text Add to dashboard Cite

IntroductionBuruli Ulcer (BU) is caused by the environmental microbe Mycobacterium ulcerans. Despite unclear transmission, contact with a BU endemic region is the key known risk factor. In Victoria, Australia, where endemic areas have been carefully mapped, we aimed to estimate the Incubation Period (IP) of BU by interviewing patients who reported defined periods of contact with an endemic area prior to BU diagnosis.MethodA retrospective review was undertaken of 408 notifications of BU in Victoria from 2002 to 2012. Telephone interviews using a structured questionnaire and review of notification records were performed. Patients with a single visit exposure to a defined endemic area were included and the period from exposure to disease onset determined (IP).ResultsWe identified 111 of 408 notified patients (27%) who had a residential address outside a known endemic area, of whom 23 (6%) reported a single visit exposure within the previous 24 months. The median age of included patients was 30 years (range: 6 to 73) and 65% were male. 61% had visited the Bellarine Peninsula, currently the most active endemic area. The median time from symptom onset to diagnosis was 71 days (range: 34–204 days). The midpoint of the reported IP range was utilized to calculate a point estimate of the IP for each case. Subsequently, the mean IP for the cohort was calculated at 135 days (IQR: 109–160; CI 95%: 113.9–156), corresponding to 4.5 months or 19.2 weeks. The shortest IP recorded was 32 days and longest 264 days (Figure 1 & 2). IP did not vary for variables investigated.ConclusionsThe estimated mean IP of BU in Victoria is 135 days (IQR: 109–160 days), 4.5 months. The shortest recorded was IP 34 days and longest 264 days. A greater understanding of BU IP will aid clinical risk assessment and future research.

show abstract

Section: Introductionmentioning

confidence: 99%

The Incubation Period of Buruli Ulcer (Mycobacterium ulcerans Infection)

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Oedematous lesions can be extensive, rapidly progressive and lead to significant tissue loss as evidenced by 76% of lesions in our study presenting as WHO Category 2 or 3 lesions [1], [4], [5]. They are characterized by the presence of large numbers of extracellular AFBs.…”

Section: Discussionmentioning

confidence: 61%

Clinical Features and Risk Factors of Oedematous Mycobacterium ulcerans Lesions in an Australian Population: Beware Cellulitis in an Endemic Area

et al. 2014

View full text Add to dashboard Cite

IntroductionOedematous lesions are a less common but more severe form of Mycobacterium ulcerans disease. Misdiagnosis as bacterial cellulitis can lead to delays in treatment. We report the first comprehensive descriptions of the clinical features and risk factors of patients with oedematous disease from the Bellarine Peninsula of south-eastern Victoria, Australia.MethodsData on all confirmed Mycobacterium ulcerans cases managed at Barwon Health, Victoria, were collected from 1/1/1998–31/12/2012. A multivariate logistic regression model was used to assess associations with oedematous forms of Mycobacterium ulcerans disease.ResultsSeventeen of 238 (7%) patients had oedematous Mycobacterium ulcerans lesions. Their median age was 70 years (IQR 17–82 years) and 71% were male. Twenty-one percent of lesions were WHO category one, 35% category two and 41% category three. 16 (94%) patients were initially diagnosed with cellulitis and received a median 14 days (IQR 9–17 days) of antibiotics and 65% required hospitalization prior to Mycobacterium ulcerans diagnosis. Fever was present in 50% and pain in 87% of patients. The WCC, neutrophil count and CRP were elevated in 54%, 62% and 75% of cases respectively. The median duration of antibiotic treatment was 84 days (IQR 67–96) and 94% of cases required surgical intervention. On multivariable analysis, there was an increased likelihood of a lesion being oedematous if on the hand (OR 85.62, 95% CI 13.69–535.70; P<0.001), elbow (OR 7.83, 95% CI 1.39–43.96; p<0.001) or ankle (OR 7.92, 95% CI 1.28–49.16; p<0.001), or if the patient had diabetes mellitus (OR 9.42, 95% CI 1.62–54.74; p = 0.02).ConclusionsIn an Australian population, oedematous Mycobacterium ulcerans lesions present with similar symptoms, signs and investigation results to, and are commonly mistakenly diagnosed for, bacterial limb cellulitis. There is an increased likelihood of oedematous lesions affecting the hand, elbow or ankle, and in patients with diabetes.

show abstract

“…Large numbers of cases were reported from the Buruli County near the river Nile in Uganda in the early 1960s, and Cameroon 9 as well as in Australia. 10,11 Surveys for BU in the endemic African countries revealed vast underreporting. [7][8][9] Patients tend to report late or not at all to the formal health system for many reasons, including limited access to health facilities, stigmatization, and traditional beliefs, prompting them to seek treatment with traditional healers.…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and disease burden of Buruli ulcer: a review

Röltgen¹,

Pluschke

2015

RRTM

View full text Add to dashboard Cite

Buruli ulcer (BU) is a neglected tropical skin disease caused by Mycobacterium ulcerans. Infection foci occur mainly in remote, rural areas of Central and West Africa, but also in Australia and Papua New Guinea. In addition, infections caused by M. ulcerans strains of a different lineage are sporadically reported from scattered foci in Asia and the Americas. While in the past decade more than 42,000 BU cases have been reported worldwide, an assessment of the actual global disease burden is complicated by the remoteness of affected populations and a lack of data on the incidence of BU in a number of countries, from which cases have been historically reported. Moreover, as BU patients present with diverse clinical manifestations ranging from relatively unspecific nodules, plaques, or edema to necrotic, ulcerative lesions, differential diagnosis is manifold and thus clinical misclassification may occur. Since to date reservoirs and transmission pathways of M. ulcerans remain equivocal, early diagnosis and treatment of patients are key determinants to control the disease. Particularly in view of the apparent decline in BU incidence in regions of West Africa, awareness and knowledge of BU in endemic regions must be retained to ensure a continuous monitoring and control. An integrated approach for the control of tropical skin diseases should be considered to cope with this difficult task. This review article aims at providing an overview of the current global burden of BU and summarizes the state of knowledge on the various epidemiological aspects of this enigmatic disease.

show abstract

Mycobacterium ulcerans infection in North Queensland: the ‘Daintree ulcer’

Cited by 40 publications

References 20 publications

The Incubation Period of Buruli Ulcer (Mycobacterium ulcerans Infection)

The Incubation Period of Buruli Ulcer (Mycobacterium ulcerans Infection)

Clinical Features and Risk Factors of Oedematous Mycobacterium ulcerans Lesions in an Australian Population: Beware Cellulitis in an Endemic Area

Epidemiology and disease burden of Buruli ulcer: a review

Contact Info

Product

Resources

About