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|Title: ||Providing insight into the incubation period of Mycobacterium ulcerans disease: two case reports|
|Authors: ||Phillips, Richard O.|
Amoako, Y. A.
Awuah, D. O.
|Keywords: ||Buruli ulcer|
|Issue Date: ||18-Jul-2019|
|Publisher: ||Journal of Medical Case Reports|
|Citation: ||Journal of Medical Case Reports doi.org/10.1186/s13256-019-2144-2|
|Abstract: ||Background: Buruli ulcer caused by Mycobacterium ulcerans is endemic in parts of West Africa and is most prevalent
among the 5–15 years age group; Buruli ulcer is uncommon among neonates. The mode of transmission and
incubation period of Buruli ulcer are unknown. We report two cases of confirmed Buruli ulcer in human
immunodeficiency virus-unexposed, vaginally delivered term neonates in Ghana.
Case presentation: Patient 1: Two weeks after hospital delivery, a baby born to natives of the Ashanti ethnic group
of Ghana was noticed by her mother to have a papule with associated edema on the right anterior chest wall and
neck that later ulcerated. There was no restriction of neck movements. The diagnosis of Buruli ulcer was confirmed on
the basis of a swab sample that had a positive polymerase chain reaction result for the IS2404 repeat sequence of M.
ulcerans. Patient 2: This patient, from the Ashanti ethnic group in Ghana, had the mother noticing a swelling in the
baby’s left gluteal region 4 days after birth. The lesion progressively increased in size to involve almost the entire left
gluteal region. Around the same time, the mother noticed a second, smaller lesion on the forehead and left side
of neck. The diagnosis of Buruli ulcer was confirmed by polymerase chain reaction when the child was aged 4
weeks. Both patients 1 and 2 were treated with oral rifampicin and clarithromycin at recommended doses for 8
weeks in addition to appropriate daily wound dressing, leading to complete healing. Our report details two cases
of polymerase chain reaction-confirmed Buruli ulcer in children whose lesions appeared at ages 14 and 4 days,
respectively. The mode of transmission of M. ulcerans infection is unknown, so the incubation period is difficult to
estimate and is probably dependent on the infective dose and the age of exposure. In our study, lesions appeared 4
days after birth in patient 2. Unless the infection was acquired in utero, this would be the shortest incubation period
Conclusions: Buruli ulcer should be included in the differential diagnosis of neonates who present with characteristic
lesions. The incubation period of Buruli ulcer in neonates is probably shorter than is reported for adults.|
|Description: ||An article published by Journal of Medical Case Reports|
|Appears in Collections:||College of Health Sciences|
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