[Leish-l] FW: PRO/EDR> Undiagnosed skin disease - Nigeria: (SO)

BEN-ISMAIL, Dr Riadh RA/CTD ismailr at emro.who.int
Wed Oct 13 06:03:15 BRT 2010


Could it be a  myiasis   (fly larvae infestation)??

 

Dr Riadh BEN-ISMAIL 
Regional Advisor/CTD/DCD 
World Health Organization. 
Eastern Mediterranean Regional Office 
P.O. Box 7608 
Cairo 11371 EGYPT 
Direct Tel:00 20 2 22765280 
DCD  Fax:00 20 2 22765414 
email: ismailr at emro.who.int 

 

 

From: leish-l-bounces at lineu.icb.usp.br
[mailto:leish-l-bounces at lineu.icb.usp.br] On Behalf Of jeffrey shaw
Sent: Wednesday, October 13, 2010 4:04 AM
To: Leish-L
Subject: [Leish-l] FW: PRO/EDR> Undiagnosed skin disease - Nigeria: (SO)

 


Subject: Fwd: PRO/EDR> Undiagnosed skin disease - Nigeria: (SO)
From: marizashaw at gmail.com
To: jayusp at hotmail.com




---------- Forwarded message ----------
From: ProMED-mail <promed at promed.isid.harvard.edu>
Date: 2010/10/6
Subject: PRO/EDR> Undiagnosed skin disease - Nigeria: (SO)
To: promed-edr at promedmail.org



UNDIAGNOSED SKIN DISEASE - NIGERIA: (SOKOTO)
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Date: Mon 4 Oct 2010
Source: AllAfrica, Daily Trust report [edited]
<http://allafrica.com/stories/201010041232.html> [edited]


A strange skin disease that eats deep into the human body has broken
out in Sokoto, affecting a large number of the people. The disease
which is defying medical solution, is nicknamed "Mallam Fatori",
after a desert town in Borno State where it was said to have emanated
from.

Victims suffering from the disease, who spoke to Daily Trust, said
they had been carrying the ailment for 5 to 9 months now and have
visited several hospitals including the Usman Danfodio University
Teaching Hospital, Sokoto (UDUTH), but could not get any solution.

Speaking exclusively to Daily Trust in Sokoto, 2 victims, [a
27-year-old man] and a woman, said in separate interviews that the
ailment started with different parts of their body itching [? from]
mosquito bites and developed rashes when they scratched the place
which turns into deep wounds.

The [man] said, "I noticed the ailment about 5 months ago. It is
affecting 8 different parts of my body as you can see. Since then I
have been to a leprosy hospital in Kaduna, the leprosy hospital in
Amanawa near Sokoto, UDUTH, and many other hospitals, but they do not
seem to know much about it and so could not offer any positive
treatment.

"I know about 50 people that are suffering from the sickness in
Sokoto including women and children. Many of the patients watch
helplessly as the disease eats into their bodies without medical
solution. But at Amanawa hospital, the doctors said they were
suspecting it was the result of [leishmaniasis]," he said.

[The woman], who said she was infected with the disease in 2
different places on her body, said she had been suffering from it for
about 9 months now and was yet to find a cure after visiting 5
hospitals including UDUTH.

"My problem started with the affected parts itching me. When I
scratched it, boils came out. The boils remained small on the
surface, but inside my flesh, the wound had eaten deep. But the wound
does not [hurt] at all even though it keeps expanding internally. You
can see how small the boil is on the surface but this big, round
black mark is evidence that the wound has expanded internally," she
said.

When Daily Trust visited UDUTH, the head of the medicine department
of the hospital, Professor Isezua, said arrangements were being made
to properly examine one of the patients suffering from the disease to
enable him to understand it before commenting on it.

The Sokoto State commissioner for information, Alhaji Dahiru
Maishanu, said the state government did not know about the disease.
But he said the state had mobile clinics that could be deployed to
any part to handle the emergence of any type of sickness reported to
government.

[Byline: Shehu Abubakar]

--
Communicated by:
ProMED-mail
<promed at promedmail.org>

[The text mentions leishmaniasis and cutaneous leishmaniasis is a
possibility resulting in sores at the site of the bite by the
sandfly. Cutaneous leishmaniasis is found in northern Nigeria, but it
usually does not expand deep into the subcutaneous tissue. Diagnosis
is based on microscopy of fluid expressed from the edge of the wound,
which is supposed to be a well-known procedure in an endemic area.

Another possibility is tropical ulcer caused by fusiform bacteria. It
is surprising however, that this would spread as an epidemic, and it
would be possible to treat with proper antibiotics. Infection with
fusiform bacteria can spread through the subcutaneous tissue and
deeper through fascia, but the slow course over months is surprising
although it can develop into a chronic form.

A 3rd possibility is Buruli ulcer, caused by _Mycobacterium
ulcerans_, which causes a long standing chronic ulceration that can
also expand through subcutaneous tissue and penetrate fascia. This is
probably the most likely explanation for the described disease. (More
information on Buruli ulcer can be found at
<http://www.who.int/mediacentre/factsheets/fs199/en/>).

The reservoir for _Mycobacterium ulcerans_ and the transmission route
to humans are not known, but a recent study from Australia suggests
that contact with mammals is a possibility (Fyfe JA et al: A major
role for mammals in the ecology of _Mycobacterium ulcerans_. PLoS
Negl Trop Dis. 2010 Aug 10; 4(8): e791; available at
<http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0000791>)
.
- Mod.EP]

[Sokoto state, in north western Nigeria, can be located on the maps at
<http://www.un.org/Depts/Cartographic/map/profile/nigeria.pdf> and
<http://healthmap.org/r/0bXT>. - Sr.Tech.Ed.MJ]
...................................ep/mj/dk

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