Integrated Management Strategies (Diagnosis, Treatment, and Wound Care Management) for Improved Clinical Outcomes of Buruli Ulcer in Ghana: A Retrospective Case Report in the Ga West Municipal Hospital, Amasaman

Buruli ulcer is a necrotizing skin infection caused by Mycobacterium ulcerans. BU lesions may start with characteristic painlessness but most often, the typical presentations of the disease are characterized by large ulcers with undermined edges. If left untreated, BU lesions may result in extensive ulceration that can cover 15% of the body. Even though public sensitization and education have resulted in sufficient and improved knowledge about the etiology of the disease in Ghana, patients still report to health facilities with advanced forms of the disease. As a result, the management of Buruli ulcer (BU) is increasingly becoming a challenge. Therefore, this case report highlights an integrated approach comprising of clinical diagnosis, laboratory confirmation, antibiotic treatment, and wound management of four confirmed cases of Buruli ulcer diseases that were managed at the BU Ward of the Ga West Municipal Hospital. Surgical interventions including debridement and skin grafting coupled with comprehensive wound care and/or physiotherapy were also employed in instances where antibiotic therapy alone was not sufficient for complete healing. The application of integrated management led to full recovery of all the patients, albeit with different times to healing depending on the severity of the lesions.