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- Title
Changes in Inflammatory Markers in Patients Treated for Buruli Ulcer and Their Ability to Predict Paradoxical Reactions.
- Authors
Phelippeau, Michael; Marion, Estelle; Robbe-Saule, Marie; Ganlanon, Line; Chauty, Annick; Adeye, Ambroise; Blanchard, Simon; Johnson, Christian; Marsollier, Laurent; Dubee, Vincent
- Abstract
Mycobacterium ulcerans causes Buruli ulcer, the third most frequent mycobacterial disease after tuberculosis and leprosy. Transient clinical deteriorations, known as paradoxical reactions (PRs), occur in some patients during or after antibiotic treatment. We investigated the clinical and biological features of PRs in a prospective cohort of 41 patients with Buruli ulcer from Benin. Neutrophil counts decreased from baseline to day 90, and interleukin 6 (IL-6), granulocyte colony-stimulating factor, and vascular endothelial growth factor were the cytokines displaying a significant monthly decrease relative to baseline. PRs occurred in 10 (24%) patients. The baseline biological and clinical characteristics of the patients presenting with PRs did not differ significantly from those of the other patients. However, the patients with PRs had significantly higher IL-6 and tumor necrosis factor alpha (TNF-α) concentrations on days 30, 60, and 90 after the start of antibiotic treatment. The absence of a decrease in IL-6 and TNF-α levels during treatment should alert clinicians to the possibility of PR onset.
- Subjects
BENIN; BURULI ulcer; VASCULAR endothelial growth factors; GRANULOCYTE-colony stimulating factor; TUMOR necrosis factors; MYCOBACTERIAL diseases
- Publication
Journal of Infectious Diseases, 2023, Vol 228, Issue 11, p1630
- ISSN
0022-1899
- Publication type
Article
- DOI
10.1093/infdis/jiad176