Interest and limits of exudates microscopy in Mycobacterium ulcerans infection in Cote d'Ivoire.

The objective of this study was to estimate the interest and the limits of skin exudate Microscopy for patients with chronic ulceration with clinicall y suspected Buruli's ulcer and living in an endemic area in Cote d'Ivoire. Two stained smears, one with ZIEHL-NEELSEN and the other DUGOMIER staining, were produced from 140 samples obtained after a swab of skin lesions. The positive smear rate for the acid fast bacilli (AFB) was respectively 16.4% and 12.9% for DUGOMIER and ZIEHL-NEELSEN staining. The ulceration with less than one year of evolution have high AFB rates of 15.8% for ZIEHL-NEELSEN staining and 21.1% for DUGOMIER'S. Microscopic examination of skin exudate in face of ulceration, clinically suspected to be a Buruli's ulcer is not t he best tool for biological diagnosis, due to poor technical sensibility. N evertheless, it remains a good first means of investigation in an endemoepi demic area.