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Volume 9, Number 6—June 2003
Research

Histopathologic Features of Mycobacterium ulcerans Infection

Jeannette Guarner*Comments to Author , Jeanine Bartlett*, Ellen A. Spotts Whitney*, Pratima L. Raghunathan*, Ymkje Stienstra†, Kwame Asamoa‡, Samuel Etuaful§, Erasmus Klutse¶, Eric Quarshie#, Tjip S. van der Werf†, Winette T.A. van der Graaf†, C. Harold King**, and David A. Ashford*
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Groningen University Hospital, the Netherlands; ‡Ministry of Health, Accra, Ghana; §St. Martins Catholic Hospital, Agroyesum, Ghana; ¶Dunkwa Government Hospital, Dunkwa, Ghana; #Presbyterian Hospital, Agogo, Ghana; **Emory University, Atlanta, Georgia, USA

Main Article

Table 1

Histopathologic features evaluated in definitive and suspected Buruli ulcer cases

Location,
feature Comments
Epidermis
Hyperplasia
 Psoriasiform (regular downward elongation of rete ridges), or pseudoepitheliomatous (irregular elongation of rete ridges)
AFBa
 Presence or absence
Dermis
Elastolysis
 Collagen degeneration and necrosis seen as granular blue/purple collagen bundles with H&E stain
Inflammation, type
 Acute (presence of neutrophils), chronic (presence of lymphocytes and macrophages), or granulomatous (presence of multinucleated giant cells and epithelioid histiocytes)
AFB
 Presence or absence
Vascular changes
 Thickening of the media, necrosis, and inflammation of vascular walls
Subcutis
Necrosis
 Coagulative or fat necrosis
Inflammation, type
 Acute (presence of neutrophils), chronic (presence of lymphocytes and macrophages), or granulomatous (presence of multinucleated giant cells and epithelioid histiocytes)
Inflammation, intensity
 Absent, mild (scattered inflammatory cells), or intense (inflammation forming nodules or bands)
AFB Absent, mild (1–5 AFB seen with 40X objective), moderate (>6 AFB seen with 40X objective), or marked (AFB seen with 20X objective as clumps or colonies)

aH&E, hematoxylin and eosin stain; AFB, acid-fast bacilli.

Main Article

Page created: December 21, 2010
Page updated: December 21, 2010
Page reviewed: December 21, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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