University of Jordan, School of Medicine and Al Khalidi Medical Center, 29 Adeeb Wahbeh St., Amman 11118, Jordan.
Laboratory Department, Jordan Hospital and Medical Center, Amman, Jordan.
Int J Infect Dis. 2017 May;58:77-81. doi: 10.1016/j.ijid.2017.02.014. Epub 2017 Mar 23.
Buruli ulcer is the third most common mycobacterial infection worldwide. It is endemic in tropical, subtropical, and temperate climates. It causes devastating disease with morbidity and mortality. The treatment duration is long and the regimens considered are limited. Chronic cutaneous ulcers of mycobacterial etiology have been reported previously in Amman, but these were not associated with Mycobacterium ulcerans infection.
The case patient's initial diagnosis was based on chronological and morphological features, combined with appropriate diagnostic tests. The skin features were assessed histopathologically. Skin testing was positive for acid-fast bacilli (AFB), and M. ulcerans was identified by DNA strip test (GenoType Mycobacterium CM/AS, Hain Lifescience), which is based on a PCR technique targeting a 23S rRNA gene region, followed by reverse hybridization and a line probe technology.
The skin mycobacterial infection was evaluated and verified as having a Mycobacterium marinum-M. ulcerans pattern in the GenoType CM assay. It was then counted as a pattern representing individual species and was resolved with the GenoType AS assay as having an M. ulcerans pattern. M. ulcerans DNA was isolated and amplified by PCR, and then detected against reverse hybridization probes in the strip assay.
An indigenous case of M. ulcerans (Buruli ulcer) is reported for the first time from Jordan and the surrounding region.
溃疡分枝杆菌病是世界上第三大常见的分枝杆菌感染。它在热带、亚热带和温带气候中流行。它会导致严重的疾病，发病率和死亡率都很高。治疗时间长，且考虑的方案有限。以前在安曼曾报道过分枝杆菌病因的慢性皮肤溃疡，但这些与溃疡分枝杆菌感染无关。
该病例患者的初步诊断基于时间和形态特征，结合适当的诊断测试。皮肤特征通过组织病理学进行评估。皮肤测试对酸杆菌（AFB）呈阳性，通过 DNA 条带测试（GenoType Mycobacterium CM/AS，Hain Lifescience）鉴定出溃疡分枝杆菌，该测试基于针对 23S rRNA 基因区域的 PCR 技术，随后进行反向杂交和线探针技术。
对皮肤分枝杆菌感染进行评估和验证，在 GenoType CM 检测中显示出海洋分枝杆菌-溃疡分枝杆菌模式。然后将其计为代表单个物种的模式，并在 GenoType AS 检测中解决为溃疡分枝杆菌模式。通过 PCR 分离和扩增溃疡分枝杆菌 DNA，然后在条带检测中针对反向杂交探针进行检测。
报告了首例来自约旦及周边地区的本地溃疡分枝杆菌（布吕利溃疡）病例。
