{"id":7445,"date":"2020-04-24T12:56:07","date_gmt":"2020-04-24T15:56:07","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/ulcera-de-buruli\/"},"modified":"2020-04-27T16:20:18","modified_gmt":"2020-04-27T19:20:18","slug":"buruli-ulcer-2","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/ulcera-de-buruli\/","title":{"rendered":"Buruli ulcer"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/ulcera-de-buruli\/#%C2%BFQue-es-buruli-ulcera\" >What is buruli? ulcer?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/ulcera-de-buruli\/#%C2%BFCual-es-la-causa-de-la-ulcera-de-Buruli\" >What is the cause of Buruli ulcer?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/ulcera-de-buruli\/#%C2%BFQuien-contrae-la-ulcera-de-Buruli\" >Who gets Buruli ulcer?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/ulcera-de-buruli\/#%C2%BFCuales-son-las-caracteristicas-clinicas-de-la-ulcera-de-Buruli\" >What are the clinical features of Buruli ulcer?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/ulcera-de-buruli\/#%C2%BFCuales-son-las-complicaciones-de-la-ulcera-de-Buruli\" >What are the complications of Buruli ulcer?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/ulcera-de-buruli\/#%C2%BFComo-se-hace-el-diagnostico-de-la-ulcera-de-Buruli\" >How is Buruli ulcer diagnosed?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/ulcera-de-buruli\/#%C2%BFCual-es-el-tratamiento-de-la-ulcera-de-Buruli\" >What is the treatment for Buruli ulcer?<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-es-buruli-ulcera\"><\/span>What is buruli? <span class=\"term\" data-term-id=\"290\">ulcer<\/span>?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Buruli ulcer is a <span class=\"term\" data-term-id=\"1411\">necrotizing<\/span> disease (causing tissue death) of the skin and underlying tissue.<\/p>\n<p><span>Buruli ulcer is also called <\/span>Bairnsdale ulcer, Searles ulcer, Daintree ulcer and Sik-belonga-sepik.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCual-es-la-causa-de-la-ulcera-de-Buruli\"><\/span>What is the cause of Buruli ulcer?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Buruli ulcer is caused by <span class=\"term\" data-term-id=\"935\">bacteria<\/span> called <em>Mycobacterium ulcerans<\/em>. These bacteria are <span class=\"term\" data-term-id=\"1395\">atypical<\/span> mycobacteria and come from the same family of <span class=\"term\" data-term-id=\"883\">organisms<\/span> that cause leprosy and tuberculosis.<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQuien-contrae-la-ulcera-de-Buruli\"><\/span>Who gets Buruli ulcer?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Buruli ulcer is found in more than 30 tropical, subtropical, and temperate countries. Most cases occur in central and western Africa. Cases have also been reported from Australia, Southeast Asia, and Central and South America. In the last 2 decades, the <span class=\"term\" data-term-id=\"578\">incidence<\/span> of Buruli ulcer has increased, despite the significant underreporting of cases. In 1999 there were 6,000 new cases in Ghana; in Australia, there were 25 cases in 2004, 47 in 2005 and 72 in 2006. In 2018, there were more than 340 cases in the state of Victoria alone.<\/p>\n<p>Buruli ulcer predominantly affects poor rural communities living near wetlands. Although the exact mode of transmission is unknown, <em>M. ulcerans<\/em> most probable cause <span class=\"term\" data-term-id=\"145\">infection<\/span> through <span class=\"term\" data-term-id=\"1870\">inoculation<\/span> or contamination of a <span class=\"term\" data-term-id=\"1367\">traumatic<\/span> wound. In Victoria, Australia, the infection has been found in wild animals such as ring-tailed possums and in mosquitoes. It has been speculated that mycobacterial infection may follow an infected mosquito bite. <\/p>\n<p>People of any age can be affected, but most cases are in children under 15 years of age.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-caracteristicas-clinicas-de-la-ulcera-de-Buruli\"><\/span>What are the clinical features of Buruli ulcer?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>the <span class=\"term\" data-term-id=\"1618\">incubation<\/span> period varies from a few weeks to months. Buruli ulcer begins as a firm, painless ache. <span class=\"term\" data-term-id=\"198\">nodule<\/span> (swelling) on the skin, which is about 1 to 2 cm in diameter. <em>M. ulcerans<\/em> produces a <span class=\"term\" data-term-id=\"1921\">toxin<\/span>, called mycolactone, which is directly <span class=\"term\" data-term-id=\"1159\">toxic<\/span> to cells and also dampens the immune system. The toxin causes extensive tissue destruction, without any <span class=\"term\" data-term-id=\"380\">systemic<\/span> symptoms (like <span class=\"term\" data-term-id=\"1176\">fever<\/span>, <span class=\"term\" data-term-id=\"1211\">discomfort<\/span>or expanded <span class=\"term\" data-term-id=\"1775\">lymph nodes<\/span>)<\/p>\n<p>Over the next several weeks, the nodule ruptures to form a sore <span class=\"term\" data-term-id=\"770\">necrotic<\/span> ulcer with undercut edges (destruction of tissue underlying intact skin). the <span class=\"term\" data-term-id=\"403\">necrosis<\/span> may extend several centimeters beyond the edges of the ulcer, causing the <span class=\"term\" data-term-id=\"164\">injury<\/span> appears smaller than its actual size. The ulcer can spread into deeper tissues destroying <span class=\"term\" data-term-id=\"952\">nerves<\/span>, <span class=\"term\" data-term-id=\"953\">blood vessels<\/span>, muscles, and sometimes bone. The extremities, particularly the lower extremities, are the most commonly involved.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-complicaciones-de-la-ulcera-de-Buruli\"><\/span>What are the complications of Buruli ulcer?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Tissue destruction can be extensive (involving up to 15% from the patient&#039;s skin surface) and secondary infection can occur. Other complications include <span class=\"term\" data-term-id=\"1054\">osteomyelitis<\/span> (bone infection) and <span class=\"term\" data-term-id=\"1000\">metastatic<\/span> injuries (the spread of wounds to distant sites). Extensive lesions heal with scars, which can cause irreversible deformities, secondary lymphedema (swelling due to fluid retention), and restriction of joint movement. Few people die from Buruli ulcer, but it often causes long-term disability, disfigurement, and a significant socioeconomic burden.<\/p>\n<p>Antibiotic treatment can sometimes cause a paradoxical effect. <span class=\"term\" data-term-id=\"490\">inflammatory<\/span> reaction and enlargement <span class=\"term\" data-term-id=\"1278\">ulceration<\/span>.<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-hace-el-diagnostico-de-la-ulcera-de-Buruli\"><\/span>How is Buruli ulcer diagnosed?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>In <span class=\"term\" data-term-id=\"814\">endemic<\/span> areas, Buruli ulcer is often diagnosed and treated based on clinical findings.<\/p>\n<ul>\n<li>A direct smear is taken from the necrotic base of the ulcer, stained with Ziehl-Neelsen stain to reveal clusters of acidic bacilli (mycobacteria) under a microscope.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"941\">Polymerase chain reaction<\/span> (<span class=\"term\" data-term-id=\"942\">PCR<\/span>) you can quickly confirm <em>M. ulcerans<\/em> on swabs from an ulcer or tissue <span class=\"term\" data-term-id=\"24\">biopsy<\/span>.<\/li>\n<li>\n<p>Biopsy of the lesion may reveal features <span class=\"term\" data-term-id=\"868\">microscopic<\/span> changes and agglomerations of acid fast bacilli.<\/li>\n<li>\n<em>M. ulcerans<\/em> It can also be grown from swabs taken from an ulcer or from a biopsy of fresh tissue, but it takes 6 to 8 weeks or longer for the result to be reported.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCual-es-el-tratamiento-de-la-ulcera-de-Buruli\"><\/span>What is the treatment for Buruli ulcer?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Current WHO recommendations for treatment are as follows:<\/p>\n<ol>\n<li>A combination of rifampicin and streptomycin, amikacin, clarithromycin, moxifloxacin, or ciprofloxacin for eight weeks as first-line treatment for all forms of active disease. Antibiotics can promote healing of smaller lesions and decrease disease. <span class=\"term\" data-term-id=\"1074\">reappearance<\/span>. The best results occur with early treatment (<span class=\"term\" data-term-id=\"1279\">ulcers<\/span> <5 cm).<\/li>\n<li>A paradoxical flare may require oral prednisone to be added to the antibiotic regimen.<\/li>\n<li>Surgery may be necessary to remove necrotic tissue, cover skin defects, and correct deformities.<\/li>\n<li>Interventions to minimize or prevent disabilities.<\/li>\n<\/ol>\n<p>The BCG vaccine appears to offer some short-term protection (less than a year) against the disease.<\/p>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>\u00bfQu\u00e9 es buruli? \u00falcera? La \u00falcera de Buruli es una necrotizante enfermedad (que causa la muerte del tejido) de la piel y el tejido subyacente. La \u00falcera de Buruli tambi\u00e9n&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-7445","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7445","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=7445"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7445\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=7445"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=7445"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=7445"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}