title: Mycobacterium ulcerans infection (Buruli ulcer): first reported case in a traveler.
abstract: A chronic, painless sore developed over a 2-month period on the left calf of a Canadian man traveling for 8 months in Africa. A presumptive diagnosis of a Mycobacterium spp. infection was made despite initially negative biopsy and culture results, after failure of several courses of anti-bacterial antibiotics. Mycobacterium ulcerans was eventually isolated and the lesion progressed despite treatment with multiple anti-mycobacterial agents. The lesion finally responded to wide and repeated excision, aggressive treatment with anti-mycobacterial antibiotics, and split-thickness skin grafting. The isolation and treatment of this unusual organism are discussed.
authors.affiliation: Microbiology and Infectious Diseases, McGill University, Montreal, Quebec, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Semret
authors.forename: G
authors.initials: G
authors.lastname: Koromihis
authors.forename: J D
authors.initials: JD
authors.lastname: MacLean
authors.forename: M
authors.initials: M
authors.lastname: Libman
authors.forename: B J
authors.initials: BJ
authors.lastname: Ward
mesh_terms: D000328:Adult; D000349:Africa; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D003023:Cloxacillin / Q000627:therapeutic use; D004977:Ethambutol / Q000627:therapeutic use; D006801:Humans; D007871:Leg Ulcer / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use; D009165:Mycobacterium Infections, Nontuberculous / Q000175:diagnosis / Q000188:drug therapy*; D019911:Mycobacterium ulcerans / Q000187:drug effects / Q000302:isolation & purification* / Q000472:pathogenicity; D010406:Penicillins / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D017192:Skin Diseases, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D016038:Skin Transplantation; D014195:Travel; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents; D000904:Antibiotics, Antitubercular; D000995:Antitubercular Agents; D010406:Penicillins; D008795:Metronidazole; D002939:Ciprofloxacin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D004977:Ethambutol; D017291:Clarithromycin; D003023:Cloxacillin; D012293:Rifampin