Mycobacterium ulcerans disease.
Mycobacterium ulcerans disease (Buruli ulcer) is an important health problem in several west African countries. It is prevalent in scattered foci around the world, predominantly in riverine areas with a humid, hot climate. We review the epidemiology, bacteriology, transmission, immunology, pathology, diagnosis and treatment of infections. M. ulcerans is an ubiquitous micro-organism and is harboured by fish, snails, and water insects. The mode of transmission is unknown. Lesions are most common on exposed parts of the body, particularly on the limbs. Spontaneous healing may occur. Many patients in endemic areas present late with advanced, severe lesions. BCG vaccination yields a limited, relatively short-lived, immune protection. Recommended treatment consists of surgical debridement, followed by skin grafting if necessary. Many patients have functional limitations after healing. Better understanding of disease transmission and pathogenesis is needed for improved control and prevention of Buruli ulcer.
van der Werf
Tjip S
TS
Department of Medicine, University Medical Centre Groningen, University of Groningen, the Netherlands. t.s.van.der.werf@int.umcg.nl
Stienstra
Ymkje
Y
Johnson
R Christian
RC
Phillips
Richard
R
Adjei
Ohene
O
Fleischer
Bernhard
B
Wansbrough-Jones
Mark H
MH
Johnson
Paul D R
PD
Portaels
Françoise
F
van der Graaf
Winette T A
WT
Asiedu
Kingsley
K
D000354:Africa, Western; D006801:Humans; D015201:Meta-Analysis as Topic; D009165:Mycobacterium Infections, Nontuberculous / Q000453:epidemiology / Q000209:etiology / Q000276:immunology / Q000628:therapy / Q000635:transmission; D019911:Mycobacterium ulcerans / Q000472:pathogenicity*