When I first came to BMC, there was a young girl named Lamisi with an extensive ulcer across her chest. It was caused by a microbe called Mycobacterium ulcerans (in the same family as tuberculosis). It is found in tropical rain forests as are found in southern Ghana.
Lamisi’s family had been farming down south when she contracted the disease. The disease begins with a small nodule that ulcerates and spreads rapidly and often becomes secondarily infected with other organisms. The treatment includes antibiotics, but the bulk of the treatment is debridement of the ulcerated / infected tissue with wide excision into healthy tissue, because the mycobacterium spreads on the microscopic level.
This young girl basically lived at the hospital for a couple months as she had frequent debridements of her ulcer. Eventually, the doctors were able to get ahead of the infection. She received skin graft and healed well. Finally, she was discharged home.
The other day, William saw a young girl sitting up in the outpatient department eating watermelon. He took her picture and showed me. “Why does she look so familiar?” I looked at her sweet smile and said “that’s Lamisi, the girl with the buruli ulcer.” She had returned for review. Dr. Hewitt checked her wounds and said that she continues to heal well.
We have included photos from the middle stages of her debridement (courtesy of Dr. Tomas Rebora) to compare to how she is doing now.