Fine needle aspiration for the diagnosis of M. ulcerans infection and for mycolactone detection
Résumé
Over recent years, management of Buruli ulcer patients has considerably changed with advances in antibiotherapy. Antibiotherapy is particularly effective on nonulcerative forms. However, the bacteriological diagnosis in the early forms is difficult because simple and non-invasive methods are not available. In this study, the diagnostic effectiveness of the Fine Needle aspiration was evaluated on early lesions. Our results showed that PCR from FNA samples, unlike Ziehl-Neelsen staining, is very sensitive on nonulcerative forms like other standard sampling methods (biopsy and punch biopsy). Furthermore, mycolactone was detected in aspirated liquid from lesions in mouse experimentally infected by M. ulcerans and in FNA from Buruli ulcer patients. This is a crucial observation to encourage the development of diagnosis test based on mycolactone detection. Moreover, mycolactone was never detected in aspirated liquid from a patient treated by antibiotherapy. To conclude, fine needle aspiration is a simple, fast, painless, accurate and inexpensive method of sampling and could be used for diagnosis of M. ulcerans infection.