Guarner Jeannette, Bartlett Jeanine, Whitney Ellen A Spotts, Raghunathan Pratima L, Stienstra Ymkje, Asamoa Kwame, Etuaful Samuel, Klutse Erasmus, Quarshie Eric, van der Werf Tjip S, van der Graaf Winette T A, King C Harold, Ashford David A
Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Emerg Infect Dis. 2003 Jun;9(6):651-656. doi: 10.3201/eid0906.020485.
Because of the emergence of Buruli ulcer disease, the World Health Organization launched a Global Buruli Ulcer Initiative in 1998. This indolent skin infection is caused by Mycobacterium ulcerans. During a study of risk factors for the disease in Ghana, adequate excisional skin-biopsy specimens were obtained from 124 clinically suspicious lesions. Buruli ulcer disease was diagnosed in 78 lesions since acid-fast bacilli (AFB) were found by histopathologic examination. Lesions with other diagnoses included filariasis (3 cases), zygomycosis (2 cases), ulcerative squamous cell carcinomas (2 cases), keratin cyst (1 case), and lymph node (1 case). Thirty-seven specimens that did not show AFB were considered suspected Buruli ulcer disease cases. Necrosis of subcutaneous tissues and dermal collagen were found more frequently in AFB-positive specimens compared with specimens from suspected case-patients (p<0.001). Defining histologic criteria for a diagnosis of Buruli ulcer disease is of clinical and public health importance since it would allow earlier treatment, leading to less deforming sequelae.
由于布氏杆菌溃疡病的出现，世界卫生组织于1998年发起了全球布氏杆菌溃疡病倡议。这种慢性皮肤感染由溃疡分枝杆菌引起。在加纳对该疾病危险因素的一项研究中，从124个临床可疑病变处获取了足够的切除性皮肤活检标本。由于组织病理学检查发现抗酸杆菌（AFB），78个病变被诊断为布氏杆菌溃疡病。其他诊断的病变包括丝虫病（3例）、接合菌病（2例）、溃疡性鳞状细胞癌（2例）、角质囊肿（1例）和淋巴结（1例）。37个未显示AFB的标本被视为疑似布氏杆菌溃疡病病例。与疑似病例患者的标本相比，抗酸杆菌阳性标本中皮下组织和真皮胶原的坏死更为常见（p<0.001）。确定布氏杆菌溃疡病诊断的组织学标准具有临床和公共卫生重要性，因为这将允许早期治疗，减少致残后遗症。
