MYCOBACTERIUM-ULCERANS INFECTION IN A CHILD FROM ANGOLA - DIAGNOSIS BY DIRECT-DETECTION AND CULTURE

Buruli ulcer, caused by Mycobacterium ulcerans, is a chronic ulcerativ e skin disease, found predominantly in central and west Africa and Aus tralia. A boy of 2.5 years of age from Angola was admitted to our hosp ital with severe kwashiokor arid a large ulcer with undermined edges o n the left side of the thorax. Further examination revealed anaemia, h ypoproteinaemia, bacterial superinfection of the ulcer and intestinal parasites. Histological analysis shelved acid-fast bacilli and histopa thological changes typical of Buruli ulcer. M. ulcerans was detected b y PCR and culture. The patient was treated by surgical excision of dis eased skin, followed by split-Skin grafting. He also received antibiot ic therapy (ciprofloxacin, clarithromycin, rifabutin, and dapsone). Af ter six months, the child was discharged from hospital in good conditi on. This is the first published case of Buruli ulcer from Angola.