Have you had about Buruli Ulcer (BU)?

Buruli ulcer is a chronic debilitating disease caused by Mycobacterium ulcerans.
It often affects the skin and sometimes bone, and can lead to
permanent disfigurement and long-term disability.

At least 33 countries with tropical, subtropical and temperate climates

have reported Buruli ulcer in Africa, South America, and

Western Pacific regions.

In Australia, an increasing number of cases have been reported since 2013.

• Partial data from 13 countries for 2017 shows 2206 cases compared to 1920 in 2016;
• Australia and Nigeria reporting most cases.

Causative Organism

It is caused by bacteria called Mycobacterium ulcerans.

The organism produces a unique toxin – mycolactone – which causes tissue damage

and inhibits the immune response.

HOW IS TRANSMITTED?

The mode of transmission is not known and there is no prevention for the disease.

Signs and symptoms

It starts with swelling on the skin.

It affects any part of the body mostly the skin of the leg, arm, head.

It is usually painless.

It causes loss of sensation around the affected area

(Usually, the person will not pain or touch at the affected part).

The affected part swells leading to an ulceration (wound) after weeks.

The skin degenerates after weeks leading to the ulcer.

Occasionally, bone is affected causing gross deformity.

DIAGNOSIS

Clinically swelling/ wound from Buruli ulcer is usually painless,

with loss of sensation compare to other inflammatory conditions e.g

cellulitis where there will be redness with associated pain, fever etc.

However, Buruli Ulcer is usually diagnosed in the laboratory

through various investigation.(IS2404 polymerase chain reaction

(PCR),

Direct microscopy,Histopathology and Culture).

TREATMENT

The combination of antibiotics remain the only options

(RIFAMPICIN+ STREPTOMYCIN),

RIFAMPICIN + CLARITHROMYCIN.

Wound dressing, wound debridement and skin graft are used to speed up

the healing process.

PREVENTION

There is no option to prevent BU since the mode of

contacting the infection is unknown.

CONTROL.

When the infection is Identify, the goal is to minimize disability/ deformity,

in cases that have been established, long time goal is to help

the patient recovers from the damage.

REFERENCES

Buruli ulcer (Mycobacterium ulcerans infection)

http://www.who.int/news-room/fact-sheets/detail/buruli-ulcer-(mycobacterium-ulcerans-infection) 2018.