Download Diagnosis: Mycobacterium ulcerans Comment: Discovered in 1948

Diagnosis: Mycobacterium ulcerans
Comment:
Discovered in 1948 by Australian scientists investigating clusters of skin ulcer
patients in Bairnsdale. Found in 33 countries (WHO) , most commonly in West and
Central Africa.
The environmental reservoir and mode of transmission is unknown, with no person
to person transmission. There is negligible risk outside endemic areas.
Clincially lesions present as slow growing papules which progress to necrosis and
and undermined ulcer. Histology shows a necrotising dermatitis which can extend
into the panniculus. Acid fast stains will document bacteria, and PCR can confirm
type.
Treatment is now largely medical with 8 weeks of combination antibiotics curative.
Surgical excision may be effective if antibiotics contraindicated.
References:
MJA 2007; 186 (2) 64-68 Consensus recommendations for diagnosis, treatment and
control of Mycobacterium ulcerans infection (Bairnsdale or Buruli ulcer) in Victoria,
Australia
MJA 2014; 200 (5) 267-270 Treatment and prevention of Mycobacterium ulcerans
infection (Buruli ulcer) in Australia: guideline update
Weedon’s Skin Pathology, 4th Edition, James W Patterson