Antivenom may be given intramuscularly, because of the small volume involved. Adrenaline need not be given beforehand, unless the patient has prior exposure to equine antivenom or antitoxin or has an allergy to equine protein, in which case steroids should be given for four days as well. AVRU red back pages . Amputation has been required for severe necrosis, and ulcer recurrence may last for years. Strep pyogenes or mycobacterium ulcerans have been causatively implicated, however new evidence suggests that mycobaterium ulcerans may not play a significant role in the syndrome.
Treatment depends on severity.
Please review the literature. If an area of redness and blistering develop, the limb should be elevated and the patient rested. No drug treatments, including antibiotics, have been clearly shown to be effective at this stage. Blisters may be cultured and a microbiologist needs to be involved to look for mycobacteria as well as other bacteria. Antibiotics should be administered on positive culture or on reasonable suspicion of secondary infection, however poor clinical response is to be expected.