Concurrence of Human Immunodeficiency Virus Infection and Buruli Ulcer, A Neglected Tropical Disease in a Paediatric Patient – A Case Report

Abstract

We present a case report on the co-existence of human immunodeficiency virus infection and a seemingly
rare neglected tropical disease, Buruli ulcer, in a two-year-old female born to a mother living with HIV infection.
This case report aims to sensitize clinicians and healthcare providers about Buruli ulcers, its risk factors
(including HIV infection), the importance of prompt tissue diagnosis, and the benefits of multidisciplinary care
for optimal case outcomes.

A two-year-old female retroviral-positive child of a mother with HIV was referred to our facility following
a year's history of weight loss, seven-month history of progressive abdominal swelling and three-week
history of a non-healing back ulcer. The ulcer increased in size despite antimicrobial treatment and other supportive care from referral hospitals. However, a wound biopsy at our centre confirmed the diagnosis of a Buruli ulcer. She was managed non-operatively with nutritional support, wound dressing and antibiotics. The wound gradually reduced in size. The patient also demonstrated clinical improvement: weight gain and increased tolerance to physical effort. The doctors discharged her after 42-days admission.

It is imperative to maintain a high index of suspicion when managing patients with non-healing ulcers and thoroughly investigating, as the seemingly low incidence of many NTDs may be due to underdiagnosis and underreporting.