@article{fdi:010062347,
  title = {{R}{\'e}ponses et r{\'e}actions paradoxales au cours du traitement m{\'e}dicamenteux de l'infection {\`a} {M}ycobacterium ulcerans (ulc{\`e}re de {B}uruli). {Q}uatre observations en {G}uyane fran{\c{c}}aise = {P}aradoxical reactions and responses during antibiotic treatment for {M}ycobacterium ulcerans infection ({B}uruli ulcer). {F}our cases from {F}rench {G}uiana},
  author = {{S}ambourg, {E}. and {D}ufour, {J}. and {E}douard, {S}. and {M}orris, {A}aron and {M}osnier, {E}. and {R}eynaud, {Y}. and {S}ainte-{M}arie, {D}. and {N}acher, {M}. and {G}u{\'e}gan, {J}ean-{F}ran{\c{c}}ois and {C}ouppi{\'e}, {P}.},
  editor = {},
  language = {{FRE}},
  abstract = {{B}ackground. {I}n recent years, first-line therapy for {M}ycobacterium ulcerans infection in {F}rench {G}uiana has consisted of antibiotics active against this organism. {T}wo regimens are used comprising rifampicin associated with clarithromycin or amikacin. {P}atients and methods. {W}e describe four patients presenting apparent worsening of their lesions during treatment: ulceration of a nodular lesion in a 32-year-old woman and worsening of an ulcerated lesion in three patients aged 16, 27 and 79 years. {D}iscussion. {I}n these 4 patients, we concluded that the symptoms were caused by a paradoxical response or a reaction, a phenomenon already described in tuberculosis and leprosy. {S}uch worsening is transient and must not be misinterpreted as failure to respond to treatment. {T}he most plausible pathophysiological hypothesis involves the re-emergence of potentially necrotizing cellular immunity secondary to the loss of mycolactone, a necrotizing and immunosuppressive toxin produced by {M}. ulcerans, resulting from the action of the antibiotics.},
  keywords = {{M}ycobacterium ulcerans ; {B}uruli ulcer ; {P}aradoxical reaction ; {T}ropical disease ; {F}rench {G}uiana ; {GUYANE} {FRANCAISE}},
  booktitle = {},
  journal = {{A}nnales de {D}ermatologie et de {V}{\'e}n{\'e}r{\'e}ologie},
  volume = {141},
  numero = {6-7},
  pages = {413--418},
  ISSN = {0151-9638},
  year = {2014},
  DOI = {10.1016/j.annder.2014.01.010},
  URL = {https://www.documentation.ird.fr/hor/fdi:010062347},
}