Presumptive Diagnosis of Buruli Ulcer based on Clinical Presentations

Abstract

Objectives: Buruli ulcer disease (BUD) is a neglected tropical disease of the skin, subcutaneous tissue and occasionally bone. Except in endemic areas, the diagnosis of BUD can be a challenge. This study was an attempt to presumptively identify cases of Buruli ulcer in the absence of a laboratory confirmation. Methods: A presumptive diagnosis of Buruli ulcer by directly comparing clinical presentations with WHO-confirmed pictorial images of the disease was carried out on patients with suspected Buruli ulcers presenting to two government-owned hospitals in Ogun State, South-West, Nigeria. Results: Eighteen suspected cases of BUD from as many outpatients were identified within a three-month period, comprising 13 (72.2%) females and five (27.8%) males. 10 (55.6%) and eight (44.4%) of them were from the tertiary and secondary health facilities, respectively. Eleven (61%) of the ulcers were located on the leg, four (22%) on the breast and four (22%) on the hand. 14 (77.8%) of the patients were above 40 years of age, two (11.1%) were between 18 and 30 years while only two (11.1%) were below 15 years. 16 (89%) of the patients could not remember how the ulcer started while two (11%) of them said their lesions started with a scratch. 7(39%) of the ulcers were painless; 11 (61%) were minimally painful while 15 (83%) had undermined edges which are presentations consistent with Buruli ulcer disease. Conclusions: The detection of these ulcers in just two hospitals and within a period of three months is significant and suggestive of Buruli ulcer being probably more prevalent in South-west Nigeria than aforethought. J Microbiol Infect Dis 2017; 7(1): 36-41