Basidiobolomycosis Simulating a Mycobacterium ulcerans Infection in a Togolese Rural Child

Received Aug 17, 2017; Accepted Sep 26, 2017

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1. Introduction

Basidiobolomycosis is a rare childhood mycosis which preferentially affects rural young people in tropical countries mainly in Africa, Asia, and Latin America [1–5]. The disease is most often clinically recognized by the presence of one or more well-defined, homogeneous, dermohypodermal plaques, movable in relation to the deep plane and essentially located at the root of the limbs [1, 2, 6, 7]. We report an atypical case of basidiobolomycosis with multiple ulcers, simulating a Buruli ulcer in a Togolese rural child.

2. Case Report

A 5-year-old boy, living in a rural area, was seen in a dermatology unit for ulcers in the buttocks, at the back and right flank that had been evolving for 4 months. The lesions began 17 months earlier with a painless nodule in the right lumbar fossa which evolved in two months to a painless plaque extending to the back and right flank and then ulcerated. The child was completely vaccinated. There was no history of preexisting wound on the back and right flank of the child. On physical examination, we found an infiltrated plaque, with sharp edges, little painful, located on the buttocks, back, and the right flank. On this plaque, there were multiple hollow ulcers with polycyclic contours and fibrinous bottom (Figure 1). There were inguinal inflammatory lymph nodes. The patient had an altered general condition and was confined to bed. Physical examination of other organs was normal. The diagnosis of Buruli ulcer was discussed, but polymerase chain reaction test for Mycobacterium ulcerans