Burulijski čir

Burulijski čir (poznat i kao Bairnsdaleov, Searlsov ili Daintreejev čir[1][2][3]) jest zarazna bolest koju uzrokuje Mycobacterium ulcerans.[4] Ranu fazu infekcije karakteriziraju bezbolni čvorovi ili područja oticanja.[4] Ovi čvorovi mogu se pretvoriti u čir.[4] Čir može biti veći unutra nego na površini kože[5] i može biti okružen otokom.[5] Kako se bolest pogoršava, može doći do infekcije kosti.[4] Burulijski čirevi najčešće se javljaju na rukama ili nogama;[4] groznica nije uobičajena.[4]

Uzrok

M. ulcerans oslobađa toksin poznat kao mikolakton, koji narušava imunosupresiju i rezultira odumiranjem tkiva.[4] Bakterije iz iste porodice takođe izazivaju tuberkulozu i gubu (M. tuberculosis i M. leprae).[4] Ne zna se kako se bolest širi.[4] Moguće je da su izvori vode uključeni u širenje bolesti.[5] Zaključno sa 2013. godinom, ne postoji efikasna vakcina.[4][6]

Liječenje

Kod ranog liječenja terapija antibioticima u trajanju od 8 sedmica efektivna je u 80% slučajeva.[4] Terapija često uključuje lijekove rifampicin i streptomicin.[4] Klaritromicin ili moksifloksacin ponekad se koriste umjesto streptomicina.[4] Druge terapije mogu uključivati hirurško uklanjanje čira.[4][7] Nakon zaliječenja infekcije na zaraženom području obično ostaje ožiljak.[6]

Epidemiologija

Burulijski čirevi najčešće se pojavljuju u ruralnim oblastima supsaharske Afrika, pogotovo u Obali Slonovače, ali se mogu javiti i u Aziji, na zapadnom Pacifiku i u Americi.[4] Zabilježeni su slučajevi u više od 32 zemlje.[5] Svake godine javi se oko 5.000 do 6.000 slučajeva.[4] Osim kod ljudi, bolest se javlja i kod nekih životinja.[4] Burulijski čir prvi je opisao Albert Ruskin Cook 1897.[5]

Reference

  1. ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. str. 340. ISBN 0-7216-2921-0. Eksplicitna upotreba et al. u: |author= (pomoć)CS1 održavanje: više imena: authors list (link)
  2. ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. Chapter 74. ISBN 1-4160-2999-0.CS1 održavanje: više imena: authors list (link)
  3. ^ Lavender CJ, Senanayake SN, Fyfe JA; et al. (januar 2007). "First case of Mycobacterium ulcerans disease (Bairnsdale or Buruli ulcer) acquired in New South Wales". Med. J. Aust. 186 (2): 62–3. PMID 17223764. Eksplicitna upotreba et al. u: |author= (pomoć)CS1 održavanje: više imena: authors list (link)
  4. ^ a b c d e f g h i j k l m n o p q "Buruli ulcer (Mycobacterium ulcerans infection) Fact sheet N°199". World Health Organization. juni 2013. Pristupljeno 23. 2. 2014.
  5. ^ a b c d e Nakanaga, K; Yotsu, RR; Hoshino, Y; Suzuki, K; Makino, M; Ishii, N (2013). "Buruli ulcer and mycolactone-producing mycobacteria". Japanese journal of infectious diseases. 66 (2): 83–8. PMID 23514902.
  6. ^ a b Einarsdottir T, Huygen K (novembar 2011). "Buruli ulcer". Hum Vaccin. 7 (11): 1198–203. doi:10.4161/hv.7.11.17751. PMID 22048117.
  7. ^ Sizaire V, Nackers F, Comte E, Portaels F (2006). "Mycobacterium ulcerans infection: control, diagnosis, and treatment". Lancet Infect Dis. 6 (5): 288–296. doi:10.1016/S1473-3099(06)70464-9. PMID 16631549.CS1 održavanje: više imena: authors list (link)

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