Content area
Full text
About the Authors:
Daniel P. O’Brien
Roles Conceptualization, Data curation, Formal analysis, Methodology, Writing - original draft, Writing - review & editing
* E-mail: [email protected]
Affiliations Department of Infectious Diseases, Barwon Health, Geelong, Australia, Department of Medicine and Infectious Diseases, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia, Manson Unit, Médecins Sans Frontières, London, United Kingdom
ORCID http://orcid.org/0000-0001-5418-3330
N. Deborah Friedman
Roles Data curation, Methodology, Writing - review & editing
Affiliation: Department of Infectious Diseases, Barwon Health, Geelong, Australia
Anthony McDonald
Roles Data curation, Methodology, Writing - review & editing
Affiliation: Department of Plastic Surgery, Barwon Health, Geelong, Australia
Peter Callan
Roles Data curation, Methodology, Writing - review & editing
Affiliation: Department of Plastic Surgery, Barwon Health, Geelong, Australia
Andrew Hughes
Roles Data curation, Methodology, Writing - review & editing
Affiliation: Department of Infectious Diseases, Barwon Health, Geelong, Australia
Aaron Walton
Roles Data curation, Methodology, Writing - review & editing
Affiliation: Department of Infectious Diseases, Barwon Health, Geelong, Australia
Eugene Athan
Roles Data curation, Methodology, Writing - review & editing
Affiliation: Department of Infectious Diseases, Barwon Health, Geelong, AustraliaAbstract
Background
Healing times following treatment with antibiotics, and factors that influence healing, have not been reported in Australian patients with Mycobacterium ulcerans.
Methodology/Principal findings
Healing times were determined for all M. ulcerans cases treated by a single physician with antibiotics at Barwon Health, Victoria, from 1/1/13-31/12/16. Lesions were categorised by induration size: category A ≤ 400mm2, Category B 401-1600mm2 and Category C ≥1601mm2. A logistic regression analysis was performed to determine risk factors for prolonged wound healing (>150 days from antibiotic commencement).
163 patients were included; 92 (56.4%) were male and median age was 58 years (IQR 39-73 years). Baseline lesion size [available in 145 (89.0%) patients] was categorised as A in 46 (31.7%), B in 67 (46.2%) and C in 32 (22.1%) patients. Fifty (30.7%) patients had surgery. In those treated with antibiotics alone, 83.0% experienced a reduction in induration size after 2 weeks, then 70.9% experienced an increase in induration size from the lowest point, and 71.7% experienced an increase in ulceration size. A linear relationship existed between the time induration resolved and wound healing began.
Median time to heal was 91 days (IQR 70-148 days) for category A lesions; significantly shorter than for...