Buruli ulcer and Noma Flashcards
What is Buruli ulcer and what causes it?
Buruli ulcer is a disease caused by Mycobacterium ulcerans. It is the third most common mycobacterial disease after tuberculosis and leprosy in non-HIV-infected patients. The disease is endemic in swampy areas of West Africa but can be seen elsewhere.
How is Buruli ulcer transmitted?
Buruli ulcer is transmitted through mild injuries, with the bacillus probably residing in muddy water. Patients are usually children.
What is the slow form of Buruli ulcer and how does it present?
The slow form of Buruli ulcer develops over 2-3 months. It begins as a hard, indurated plaque with surrounding severely constricting edema. This can compromise circulation in the affected limb, leading to ischemia and necrosis.
What is the fast form of Buruli ulcer and how does it present?
The fast form of Buruli ulcer develops in 2-4 weeks. It starts as a painless papule or nodule that ulcerates and extends rapidly. The typical ulcer has undermined edges. The patient is not sick and there is no edema
What are the potential complications of Buruli ulcer?
Complications of Buruli ulcer include very extensive ulceration, secondary infection leading to sepsis, tetanus, and death. Deeper structures, including bones, may be involved, leading to osteomyelitis.
What is the primary management strategy for Buruli ulcer?
The primary management strategy for Buruli ulcer is surgery. This involves wide excision of the ulcer with skin grafting as soon as possible. There is no effective medical treatment.
How can complications from Buruli ulcer be prevented?
To manage Buruli ulcer, it is crucial to prevent secondary infections, which can lead to severe complications like sepsis, tetanus, and death.
What is Noma/Cancrum Oris?
Noma, or Cancrum Oris, is a form of infectious gangrene of the mouth, thought to be caused by fusiform bacteria. It typically affects malnourished children between 2 to 7 years of age.
What are the risk factors for developing Noma?
Children who are malnourished, especially those with protein deficiency, hypovitaminosis, and recurrent acute infections, are at increased risk for developing Noma.
How does Noma/Cancrum Oris typically progress?
Noma usually starts as peridontitis, then progresses to ulcerative stomatitis on one side of the mouth. It can advance to gangrene with extensive sloughing of adjacent tissue and necrosis of bone, resulting in a foul-smelling and very painful area.
What are the potential outcomes of untreated Noma
Untreated Noma may result in death or severe handicap due to the extensive tissue and bone damage caused by the disease.
What is the first step in managing Noma/Cancrum Oris?
Start treatment as soon as the diagnosis is suspected to prevent the disease from progressing.
How can the development of Noma be prevented when only peridontitis is present?
Oral hygiene, such as using chlorhexidine mouthwash, can help prevent the development of Noma when only peridontitis is present.
What is the antibiotic treatment for Noma?
Administer massive doses of penicillin for at least 2 weeks, or use broad-spectrum antibiotics in case of penicillin allergy. Continue treatment until all signs of activity have ceased.
What nutritional support should be provided in the management of Noma?
An intensive high-protein diet should be provided, both orally and parenterally, along with vitamin supplements to support recovery
How can tissue defects from Noma be managed?
Early treatment may significantly improve tissue defects. Remaining deformities may require surgical repair.
