Buruli ulcer: clinical pathological study of 23 patients in Lambaréné, Gabon.
Within one year 23 patients in Lambaréné (Gabon) were diagnosed as having a Buruli ulcer (advanced cases with undermined margins). The majority of the ulcers were found in children; with the exception of one ulcer on the thorax, all ulcerations were localised at the extremities. The mode of transmission could not be clarified; extensive water tests for Mycobacterium ulcerans were negative. Observed under an electron microscope, M. ulcerans has a similar structure as other mycobacteria. Exudative inflammatory processes predominate in the ulcer floor. The small blood vessels play a considerable role in the pathological process. The mycobacteria are present in this layer, below this there is widespread necrosis of adipose tissue. The margin of the ulcer displays a granulomatous inflammatory reaction. The cytological characteristics of the mesenchymal reaction of a Buruli ulcer are described with the aid of electron microscope photographs.
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Burchard
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Bierther
D002455:Cell Division; D002648:Child; D005122:Exudates and Transudates / Q000166:cytology; D005260:Female; D005347:Fibroblasts / Q000473:pathology; D006098:Granulocytes / Q000473:pathology; D006099:Granuloma / Q000473:pathology; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D009164:Mycobacterium Infections / Q000473:pathology*; D009165:Mycobacterium Infections, Nontuberculous / Q000473:pathology*; D009170:Nontuberculous Mycobacteria / Q000648:ultrastructure; D012874:Skin Diseases, Infectious / Q000473:pathology*; D012883:Skin Ulcer / Q000473:pathology*