title: Epidemiology and management of Buruli ulcer.
abstract: Buruli ulcer (Mycobacterium ulcerans infection) is a neglected tropical disease of skin and subcutaneous tissue that can result in long-term cosmetic and functional disability. It is a geographically restricted infection but transmission has been reported in endemic areas in more than 30 countries worldwide. The heaviest burden of disease lies in West and Sub-Saharan Africa where it affects children and adults in subsistence agricultural communities. Mycobacterium ulcerans infection is probably acquired via inoculation of the skin either directly from the environment or indirectly via insect bites. The environmental reservoir and exact route of transmission are not completely understood. It may be that the mode of acquisition varies in different parts of the world. Because of this uncertainty it has been nicknamed the 'mysterious disease'. The therapeutic approach has evolved in the past decade from aggressive surgical resection alone, to a greater focus on antibiotic therapy combined with adjunctive surgery.
authors.affiliation: Department of Infectious Diseases, Austin Hospital, Victoria 3084, Australia.
authors.forename: Gene Khai Lin
authors.initials: GK
authors.lastname: Huang
authors.forename: Paul D R
authors.initials: PD
authors.lastname: Johnson
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D054312:Buruli Ulcer / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy / Q000635:transmission; D004197:Disease Reservoirs / Q000382:microbiology; D006801:Humans; D019911:Mycobacterium ulcerans; D058069:Neglected Diseases / Q000453:epidemiology / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D015995:Prevalence; D015047:Zoonoses / Q000453:epidemiology / Q000473:pathology / Q000628:therapy / Q000635:transmission
chemical_list: D000900:Anti-Bacterial Agents
keywords: Buruli ulcer; Insertion sequence IS2404; Mycobacterium ulcerans; WHO neglected tropical disease; clarithromycin; fluroquinolones; mycolactone; paradoxical reaction; rifampicin; streptomycin