Ultrasonography for the monitoring of subcutaneous damage in Mycobacterium ulcerans infection (Buruli ulcer)
| Autor: | Claudio Clemente, Antonino Sarno, Anna Clelia Lucia Gambaro, Teresa Cammarota, Roch Christian Johnson, Francesco Poggio, Alessandro Carriero, Ghislain Emmanuel Sopoh, Fabrizio Leigheb, Ange Dodji Dossou, Elisa Zavattaro, Giorgio Leigheb |
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| Rok vydání: | 2007 |
| Předmět: |
Buruli ulcer
Adult Male Pathology medicine.medical_specialty Acoustics and Ultrasonics Adolescent Biopsy Biophysics Adipose tissue Physical examination Necrosis Subcutaneous Tissue Medicine Humans Radiology Nuclear Medicine and imaging Lymphedema Child Pathological Buruli Ulcer Skin Ultrasonography Radiological and Ultrasound Technology biology medicine.diagnostic_test business.industry Echogenicity Soft tissue Middle Aged biology.organism_classification medicine.disease Adipose Tissue Mycobacterium ulcerans Child Preschool Female Lymph Lymph Nodes business |
| Zdroj: | Ultrasound in medicinebiology. 34(10) |
| ISSN: | 1879-291X |
| Popis: | We used ultrasonography to evaluate the nature and the extent of subcutaneous damage provoked by Mycobacterium ulcerans (M. ulcerans) and to investigate the possible involvement of the tributary lymph nodes during the various stages of progression of Buruli ulcer. Nineteen patients affected by M. ulcerans infection in Benin, West Africa, were studied. Ultrasonography was performed on all subjects, except one, at the site of nonulcerated lesions and/or at perilesional site. The tributary lymph nodes were also studied in six patients. Ultrasound (US) evaluation was carried out using a 10 MHz linear probe and all lesions were compared with the homologous unaffected controlateral site. The ultrasonography showed relevant alterations at the dermo-hypodermic level, in agreement with histological specimens. In the active forms of the disease, these alterations are characterized by significant oedematous imbibition of the adipose tissue and necrosis (adiponecrosis) that leads to varying irregularities in the echogenicity of the hypodermis, which is generally thicker. In agreement with the clinical examination, the lymph nodes in six patients evaluated, despite their possible histological involvement with necrotic phenomena described in literature in M. ulcerans infection, did not display significant alterations visible by ultrasonography. The US scanning we have performed is the first use of this technique for M. ulcerans infection. We have shown that it can reveal the subcutaneous depth and the peripheral extent of the pathological process and it is particularly useful for monitoring the efficacy of or resistance to antibiotic treatment, especially in extensive ulcero-oedomatose forms. Such monitoring offers also a useful guide to the surgeon allowing the reduction or postponement of the removal of the large cutaneous areas that were carried out until recently. (E-mail: dermo@maggioreosp.novara.it ) |
| Databáze: | OpenAIRE |
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