title: Clinical and histologic features of skin lesions in a cynomolgus monkey experimentally infected with mycobacterium ulcerans (Buruli ulcer) by intradermal inoculation.
abstract: Buruli ulcer, caused by Mycobacterium ulcerans, is a destructive infection that most commonly affects the skin. Animal models for Buruli ulcer include guinea pigs, rats, mice, and armadillos, but each is limited in replicating the spectrum of human disease. Here, a cynomolgus monkey was infected with two concentrations of M. ulcerans (1.0 and 2.2 x 10(8)) by intradermal inoculation, 3 months apart. All injection sites developed papules that progressed to ulcers with undermined borders within 2-4 weeks. The rate of progression and size of the ulcers were proportional to the numbers of organisms inoculated. Biopsies from ulcer edges showed ulceration, robust inflammatory cell infiltrates, granulomatous-like responses, mild edema, and extracellular acid-fast bacilli. The ulcers healed spontaneously between Weeks 8 and 12, with no signs of systemic infection. This report, the first to describe a non-human primate experimentally infected with M. ulcerans, suggests that cynomolgus monkeys are modestly susceptible and develop some of the clinical and histologic features of Buruli ulcer.
authors.affiliation: Department of Immunology and Medicine, US Army Medical Component, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand. dwalsh@wrp-ksm.org
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Walsh
authors.forename: Eduardo C
authors.initials: EC
authors.lastname: Dela Cruz
authors.forename: Rodolfo M
authors.initials: RM
authors.lastname: Abalos
authors.forename: Esterlina V
authors.initials: EV
authors.lastname: Tan
authors.forename: Gerald P
authors.initials: GP
authors.lastname: Walsh
authors.forename: Françoise
authors.initials: F
authors.lastname: Portaels
authors.forename: Wayne M
authors.initials: WM
authors.lastname: Meyers
mesh_terms: D000818:Animals; D007271:Injections, Intradermal; D008252:Macaca fascicularis / Q000382:microbiology*; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000382:microbiology* / Q000473:pathology*; D019911:Mycobacterium ulcerans; D017192:Skin Diseases, Bacterial / Q000382:microbiology* / Q000473:pathology*