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

Wed Oct 13 14:00:41 BRT 2010

Hi ! The absence of pain described by one patient is compatible with  
leishmaniasis, but also is a feature of Buriuyli's ulcer.
In any case, we woud be interested here in typing any Leishmania  
isolate from this area (or even sore samples if they are not  
cultivated)..
Best regards
P. Bastien

Professeur Patrick Bastien
National Reference Centre for Leishmania
Laboratoire de Parasitologie-Mycologie, Faculté de Médecine
UMR2724 CNRS / Université Montpellier 1 / IRD
CHU de Montpellier
39 Avenue Charles Flahault
34295 Montpellier Cedex 5
France

jeffrey shaw <jayusp at hotmail.com> a Ã©critÂ :

>
>
> 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)
>
> ********************************************
>
> A ProMED-mail post
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> <http://www.promedmail.org>
>
> ProMED-mail is a program of the
>
> International Society for Infectious Diseases
>
> <http://www.isid.org>
>
>
>
> 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
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> 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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