Mycobacterium ulcerans is a bacterial species responsible for causing Buruli ulcer, a neglected tropical disease. Buruli ulcer is a chronic skin and soft tissue infection that can lead to significant tissue destruction if left untreated. This disease is primarily found in certain tropical and subtropical regions, especially in West and Central Africa, but cases have been reported in other parts of the world as well.
Causative Agent: Mycobacterium ulcerans is a slow-growing, acid-fast bacterium. It is a close relative of Mycobacterium tuberculosis, the bacterium responsible for tuberculosis, and Mycobacterium leprae, the bacterium responsible for leprosy.
Transmission: The exact mode of transmission is not fully understood, but it is believed to be primarily environmental. It is thought that M. ulcerans enters the body through breaks in the skin, such as cuts, insect bites, or abrasions.
Clinical Presentation: Buruli ulcer typically presents as a painless nodule or swelling on the skin that may progress to larger ulcers with characteristic undermined edges. If left untreated, it can lead to significant tissue destruction and functional disability.
Diagnosis: The diagnosis of Buruli ulcer usually involves clinical examination, microbiological tests, and PCR (polymerase chain reaction) to detect the presence of Mycobacterium ulcerans DNA in clinical samples. Differential diagnoses of Buruli ulcer include tropical phagedenic ulcers, chronic lower leg ulcers due to arterial and venous insufficiency (often in elderly populations), diabetic ulcers, cutaneous leishmaniasis, extensive ulcerative yaws and ulcers caused by Haemophilus ducreyi.
Treatment: Early detection and appropriate antibiotic treatment are crucial to prevent the progression of the disease. The main antibiotic used for the treatment of Buruli ulcer is rifampicin, often in combination with other antibiotics like clarithromycin or streptomycin. In severe cases, surgical intervention may be necessary to remove necrotic tissue.
Prevention: Preventative measures for Buruli ulcer include avoiding exposure to stagnant or slow-flowing water bodies, using protective clothing to prevent insect bites, and early wound care and hygiene practices. There is no available vaccine.
Epidemiology: Buruli ulcer is more common in rural areas with limited access to healthcare and resources. Children and young adults are most commonly affected.
