Management of complications of Mycobacterium ulcerans disease: A three-year review

Abstract

Whilst ulcers, the commonest MU lesions, are being controlled with antibiotics, rare complications of the disease are also emerging.

Drugs for treating Buruli ulcer (Mycobacterium ulcerans disease)

“…Monotherapy with clofazimine for one to four weeks before surgery (Lunn 1964). Combination therapy with rifampicin + streptomycin for:12 weeks with surgery at week 4 (Kibadi 2010);eight weeks with surgery when indicated (Chauty 2007; Sarfo 2010; Adu 2013; Beissner 2015);eight weeks with surgery (Agbenorku 2011). Combination therapy with rifampicin + clarithromycin:rifampicin + clarithromycin for eight weeks, with surgery when indicated (Chauty 2011);rifampicin + streptomycin for two weeks followed by rifampicin + clarithromycin for six weeks, with surgery when indicated (Phillips 2014a).…”

“…Three RCTs, Fehr 1994; Etuaful 2005; BURULICO Study 2010, and 10 prospective observational studies, Sarfo 2010; Agbenorku 2011; Chauty 2011; O'Brien 2012; Adu 2013; O'Brien 2013b; Phillips 2014a; Beissner 2015; Barogui 2016; Friedman 2016, had laboratory confirmation as part of their inclusion criteria. The remaining included studies did not have laboratory confirmation as an inclusion criterion.…”

“…Of the prospective observational studies, seven studies measured "cure" (Phillips 2004; Kibadi 2010; Sarfo 2010; Agbenorku 2011; Chauty 2011; O'Brien 2012; Friedman 2016); one study measured "probable cure" (Chauty 2007); and three studies measured "possible cure" (Lunn 1964; Adu 2013; Beissner 2015). Healing time was investigated in five studies (Sarfo 2010; Chauty 2011; Phillips 2014a; Beissner 2015; Friedman 2016), change in ulcer size in one (Sarfo 2010), recurrence in eight (Chauty 2007; Kibadi 2010; Sarfo 2010; Agbenorku 2011; Chauty 2011; O'Brien 2012; Phillips 2014a; Beissner 2015), adverse effects in eight (Lunn 1964; Chauty 2007; Sarfo 2010; Agbenorku 2011; Chauty 2011; O'Brien 2012; Phillips 2014a; Friedman 2016), and paradoxical reactions in six studies (Sarfo 2010; O'Brien 2012; O'Brien 2013b; Phillips 2014a; Barogui 2016; Friedman 2016).…”

“…Follow‐up in the prospective observational studies was one year in six studies (Chauty 2007; Sarfo 2010; O'Brien 2012; O'Brien 2013b; Phillips 2014a; Friedman 2016). Otherwise, it was seven months in Barogui 2016, 1.5 years in Chauty 2011, two years in Agbenorku 2011 and Kibadi 2010, and not specified in Lunn 1964, Adu 2013, and Beissner 2015.…”

What Happens to Cutaneous and Musculoskeletal Sequelae of Buruli Ulcer One to Five Years after Return Home to Healed Patients

“…Other authors have also had amputation cases with proportions of 4-5% in their series. 20,21 This result may be related to the sometimes very late discovery of some patients with extensive and severe ulcer lesions. The loss of a part of the body is the most feared thing both by the patients and by the practitioners themselves.…”