[Recurrence after surgical treatment of Buruli ulcer in Cote d'Ivoire]. / Les rechutes observées après le traitement chirurgical des cas d'ulcère de Buruli en Côte d'Ivoire.

Current treatment of Buruli ulcer is mainly surgical. However, surgical management is difficult due to occurrence of more and more recurrent cases after treatment. This cross section study has been carried out from records of 346 Buruli ulcer patients who have received surgical treatment in three health centers in Cote d'Ivoire. Its purposes consisted in assessing the recurrence rate, in describing its aspects and in identifying its causes. Results showed that recurrent cases during Buruli ulcer were relatively frequent after surgery with a rate of 17.1%. They occurred early during hospitalization in an average of 5 months after surgery. They appeared mostly in ulceration form and were located on the previous lesion site. After statistical analysis, the following risk factors are associated with Buruli ulcer recurrent cases: patient under 30 years old, previous contact with a watercourse, duration of the disease exceeding 75 days before hospitalization, secondary infection before or after surgery disability, treatment by excision and skin graft, ongoing healing of operated wound. Recurrent cases after surgical treatment should not be neglected during Mycobacterium ulcerans infection. Surgeon must consider their prevention during patients treatment.

[Therapeutic approach in Mycobacterium ulcerans infections]. / Approche thérapeutique des infections à Mycobacterium ulcerans.

In Côte d'Ivoire, 88 patients of a series of 124 cases with Buruli ulcer have been able to be treated and supervised. All of them have received local cares and various antibiotics, and 23 have been treated by islet skin graft. Among the numerous antibiotics used, only Streptomycin seems to be accompanied by an acceptable failure rate. The islet-graft presents the advantage of the technical simplicity, of the good tolerance face the infection and of a good successful rate, which permits to shorten the evolution of this disabling affection. It seems to be the best adapted procedure taking into account available medical means in most of tropical countries.