Section 17. Infectious Diseases >
Part 5. Bacterial Infections >
Chapter 272. Buruli Ulcer (Mycobacterium Ulcerans Infection)Wayne M. Meyers, Françoise Portaels, and Douglas S. Walsh
Topics Discussed: buruli ulcer; infectious diseases; mycobacterium ulcerans.
Sections: Mycobacteriology and Pathophysiology, Complications, Prognosis, Prevention, References.
Excerpt:"Mycobacterium ulcerans causes indolent, necrotizing
cutaneous lesions known as Buruli ulcers, an appellation given by
Dodge and Lunn who described the first large epidemic, located in
Buruli County (now called Nakasongola), Uganda.1 Today, M
ulcerans infections are recognized to present a spectrum
of clinical disease: nodules, plaques, severe edemas and massive
ulcers in the skin, and osteomyelitis. Buruli ulcer, after tuberculosis
and leprosy, is the third most common and perhaps least understood
major mycobacterial infection. In contrast to tuberculosis and leprosy, Buruli
ulcer is closely related to environmental factors.2Endemic foci of Buruli ulcer are most common near rural permanent
wetlands in warm geographic regions, especially in areas prone to
seasonal flooding. Buruli ulcers have been reported from at least
27 countries, principally in the tropics.2 A few
patients live in nontropical regions such as China,11 Japan,12 and southern
Australia.13 The greatest number of reported patients
live in West Africa (Benin, Burkina Faso, Côte d'Ivoire,
Ghana, Guinea, Liberia, and Nigeria), with an estimated total annual
incidence exceeding 7000 patients.2,14,15 Other
known endemic countries include Angola, Cameroon, Democratic Republic
of Congo, Equatorial Guinea, French Guiana, Gabon, Indonesia, Malaysia,
Papua New Guinea, Peru, Suriname, Togo, and Uganda.16-19 The
rapid reemergence of Buruli ulcer..."
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