Back to search
Publication

Chronic cutaneous mycobacterial ulcers due to Mycobacterium ulcerans (Buruli ulcer): the first indigenous case report from Jordan and a literature review.

Abstract

Background
Buruli ulcer is the third most common mycobacterial infection worldwide. It is endemic in tropical, subtropical, and temperate climates. It causes devastating disease with morbidity and mortality. The treatment duration is long and the regimens considered are limited. Chronic cutaneous ulcers of mycobacterial etiology have been reported previously in Amman, but these were not associated with Mycobacterium ulcerans infection.

Methods
The case patient’s initial diagnosis was based on chronological and morphological features, combined with appropriate diagnostic tests. The skin features were assessed histopathologically. Skin testing was positive for acid-fast bacilli (AFB), and M. ulcerans was identified by DNA strip test (GenoType Mycobacterium CM/AS, Hain Lifescience), which is based on a PCR technique targeting a 23S rRNA gene region, followed by reverse hybridization and a line probe technology.

Results
The skin mycobacterial infection was evaluated and verified as having a Mycobacterium marinum–M. ulcerans pattern in the GenoType CM assay. It was then counted as a pattern representing individual species and was resolved with the GenoType AS assay as having an M. ulcerans pattern. M. ulcerans DNA was isolated and amplified by PCR, and then detected against reverse hybridization probes in the strip assay.

Conclusions
An indigenous case of M. ulcerans (Buruli ulcer) is reported for the first time from Jordan and the surrounding region.

More information

Type
Journal Article
Author
Al Ramahi JW
Annab H
Al Karmi M
Kirresh B
Wreikat M
Batarseh R
Yacoub M
Kaderi M
Year of Publication
2017
Journal
International journal of infectious diseases
Language
eng
DOI
10.1016/j.ijid.2017.02.014
Alternate Journal
Int. J. Infect. Dis.
Publication Language
eng