{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T06:08:57Z","timestamp":1761718137345},"reference-count":27,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:p>We report a case of under treated necrotizing fasciitis (NF) in a 65-year-old woman with diabetes misdiagnosed as <jats:italic>Mycobacterium ulcerans<\/jats:italic> infection. She came to the Institut M\u00e9dical Evang\u00e9lique (IME) with an extensive painful edematous ulcerated lesion on the dorsum of the right foot and ankle. The diagnosis of Buruli ulcer (BU) was based initially on clinical findings and place of residence (Songololo Territory, the largest known focus of BU in Bas-Congo province). Tissue specimens gave negative results for acid-fast bacilli (AFB), culture, and polymerase chain reaction (PCR) for <jats:italic>M. ulcerans.<\/jats:italic> Histopathologic analysis revealed marked necrosis of the lower dermis and subcutaneous tissue. No AFB was found. Later, scattered foci of intracellular gram-positive cocci typical of streptococci were seen. Clinicopathologic correlation of these findings strongly supported the diagnosis of NF. This patient shows the difficulties that may be encountered even in known endemic areas in recognizing BU cases purely on clinical findings.<\/jats:p>","DOI":"10.4269\/ajtmh.2010.09-0256","type":"journal-article","created":{"date-parts":[[2010,3,5]],"date-time":"2010-03-05T18:59:46Z","timestamp":1267815586000},"page":"478-481","source":"Crossref","is-referenced-by-count":7,"title":["Under Treated Necrotizing Fasciitis Masquerading as Ulcerated Edematous Mycobacterium ulcerans Infection (Buruli Ulcer)"],"prefix":"10.4269","volume":"82","author":[{"given":"Mavinga D.","family":"Phanzu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aombe E.","family":"Bafende","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bofunga B. D.","family":"Imposo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne M.","family":"Meyers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fran\u00e7oise","family":"Portaels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"year":"2000","series-title":"Buruli ulcer: Mycobacterium ulcerans infection","author":"World Health Organization","key":"R1"},{"key":"R2","series-title":"Trans R Soc Trop Med Hyg","first-page":"969","article-title":"Review: Buruli ulcer (Mycobacterium ulcerans infection)","volume":"102","author":"Walsh","year":"2008"},{"key":"R3","series-title":"Am J Trop Med Hyg","first-page":"387","article-title":"Assessing water-related risk factors for Buruli ulcer: a case-control study in Ghana","volume":"71","author":"Aiga","year":"2004"},{"key":"R4","series-title":"Clin Infect Dis","first-page":"e67","article-title":"First case of Mycobacterium ulcerans disease (Buruli ulcer) following a human bite","volume":"36","author":"Debacker","year":"2003"},{"key":"R5","series-title":"Am J Trop Med Hyg","first-page":"919","article-title":"Mycobacterium ulcerans infections developing at sites of trauma to skin","volume":"23","author":"Meyers","year":"1974"},{"key":"R6","series-title":"Ann Diagn Pathol","first-page":"386","article-title":"Mycobacterium ulcerans infection (Buruli ulcer): a case report of the disseminated nonulcerative form","volume":"4","author":"Abalos","year":"2000"},{"key":"R7","series-title":"Clin Dermatol","first-page":"291","article-title":"Buruli ulcer","volume":"27","author":"Portaels","year":"2009"},{"key":"R8","series-title":"Ann Soc Belg Med Trop","first-page":"147","article-title":"Distribution of Mycobacterium ulcerans infection in Za\u00efre, including the report of new foci","volume":"54","author":"Meyers","year":"1974"},{"year":"2001","series-title":"Buruli Ulcer: Diagnosis of Mycobacterium ulcerans disease","author":"World Health Organization","key":"R9"},{"key":"R10","series-title":"15th Edition Harrison's Manual of Medicine","first-page":"180, 378","volume":"176","author":"Braunwald","year":"2001"},{"key":"R11","series-title":"J Am Acad Dermatol","first-page":"489","article-title":"Fulminant group A streptococcal necrotizing fasciitis: clinical and pathological findings in 7 patients","volume":"47","author":"Dahl","year":"2002"},{"key":"R12","series-title":"Br Med J","first-page":"830","article-title":"Necrotising fasciitis","volume":"330","author":"Hasham","year":"2005"},{"key":"R13","series-title":"Acta Chir Belg","first-page":"29","article-title":"Necrotizing fasciitis: case report and review of literature","volume":"107","author":"Smeets","year":"2007"},{"key":"R14","series-title":"Injury","first-page":"S18","article-title":"Necrotising fasciitis of upper and lower limb: a systematic review","volume":"38S","author":"Angoules","year":"2007"},{"key":"R15","series-title":"J Int Coll Surg","first-page":"120","article-title":"The causes, pathologic aspects and treatment of phagedenic ulcer in West Africa","volume":"38","author":"Fleming","year":"1962"},{"key":"R16","series-title":"Int J Derm","first-page":"49","article-title":"The clinical and epidemiologic features of tropical ulcer (tropical phagedenic ulcer)","volume":"27","author":"Robinson","year":"1988"},{"key":"R17","series-title":"Bull Seances Acad R Sci Outre Mer","first-page":"265","article-title":"Buruli ulcer: an historical overview with updating to 2005","volume":"51","author":"Janssens","year":"2005"},{"key":"R18","series-title":"Ethiop Med J","first-page":"75","article-title":"Skin lesions in resettled and indigenous populations in Gambela, with special emphasis on the epidemiology of tropical ulcer","volume":"31","author":"Bulto","year":"1993"},{"key":"R19","series-title":"Cent Afr J Med","first-page":"413","article-title":"Tropical ulcers in a remote area in Zimbabwe","volume":"35","author":"Tumwine","year":"1989"},{"key":"R20","series-title":"Int J Tuberc Lung Dis","first-page":"816","article-title":"Scanty AFB smears: what's in a name?","volume":"8","author":"Van Deun","year":"2004"},{"key":"R21","series-title":"Am J Trop Med Hyg","first-page":"311","article-title":"Mycobacterium ulcerans disease (Buruli ulcer) in a rural hospital in Bas-Congo, Democratic Republic of Congo, 2002\u20132004","volume":"75","author":"Phanzu","year":"2006"},{"key":"R22","series-title":"Emerg Infect Dis","first-page":"1391","article-title":"Mycobacterium ulcerans disease (Buruli ulcer) in a rural hospital, Southern Benin, 1997\u20132001","volume":"10","author":"Debacker","year":"2004"},{"key":"R23","series-title":"Lancet","first-page":"1013","article-title":"Mycobacterium ulcerans infection","volume":"354","author":"van der Werf","year":"1999"},{"key":"R24","series-title":"Trop Doct","first-page":"175","article-title":"Necrotising fasciitis","volume":"34","author":"Ogundiran","year":"2004"},{"key":"R25","series-title":"Br J Dermatol","first-page":"613","article-title":"Streptococcal necrotizing fasciitis and the dermatologist","volume":"141","author":"Cox","year":"1999"},{"key":"R26","series-title":"Clin Infect Dis","first-page":"68","article-title":"Dry reagent-based polymerase chain reaction compared with other laboratory methods available for the diagnosis of Buruli ulcer disease","volume":"45","author":"Siegmund","year":"2007"},{"year":"2004","series-title":"Provisional guidance on the role of specific antibiotics in the management of Mycobacterium ulcerans disease (Buruli ulcer)","author":"World Health Organization","key":"R27"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/82\/3\/article-p478.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/82\/3\/article-p478.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/82\/3\/article-p478.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T15:51:47Z","timestamp":1725292307000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/82\/3\/article-p478.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3]]},"references-count":27,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.2010.09-0256","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2010,3]]}}}