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Lower legs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
A Buruli ulcer begins as a firm, painless, subcutaneous nodule which either heals spontaneously or ulcerates. Ulcers can remain small and heal without treatment, or spread rapidly undermining the skin over large areas, even an entire limb. It is due to Mycobacterium ulcerans, which is found in waterbugs in swamps. The organism enters the skin through a cut or abrasion, usually in children who play in and around swamps in tropical Africa or Mexico. The diagnosis can be confirmed by taking a smear from the necrotic base of the ulcer and finding acid-fast bacilli on Ziehl-Neilson stain.
BCG and Other Vaccines
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Vaccination with BCG may confer protection against non-tuberculous mycobacterial species due to cross-reactivity with conserved, often immunodominant, antigens.58 The estimates of protective efficacy against leprosy, caused by Mycobacterium leprae, vary from 20% to 90%.45,59 Although one meta-analysis determined an overall BCG-vaccine protective effect of 41% (95% CI 16–66) for trials and 60% (95% CI 51–70) for observational studies,60 another analysis reported just 26% (95% CI 14–37) and suggested that protection had been overestimated in observational studies.61 Cross-protection of BCG against Buruli ulcer disease has been reported in some studies62,63 but not in others.64,65 Murine studies have demonstrated a protective effect of BCG against infection with Mycobacterium avium and Mycobacterium kansasii.66 A study of neonates in the Czech Republic found that M. avium intracellulare complex-associated lymphadenitis was lower in BCG-vaccinated compared with unvaccinated children.38
Communicable diseases
Published in Liam J. Donaldson, Paul D. Rutter, Donaldsons' Essential Public Health, 2017
Liam J. Donaldson, Paul D. Rutter
Buruli ulcer is caused by the bacterium Mycobacterium ulcerans. Its precise mode of transmission is unknown. It starts with a painless skin nodule that leads to large ulcers on the arms and legs. Early treatment with antimicrobial drugs is often successful, but if untreated, serious complications, including deformities of the limb and serious secondary infections, occur. Early diagnosis and treatment is the main control strategy.
wIRA: hyperthermia as a treatment option for intracellular bacteria, with special focus on Chlamydiae and Mycobacteria
Published in International Journal of Hyperthermia, 2020
Nicole Borel, Anna Maria Sauer-Durand, Mark Hartel, Jasmin Kuratli, Peter Vaupel, Nicole Scherr, Gerd Pluschke
Buruli ulcer (BU), caused by infection with Mycobacterium ulcerans, is a chronic necrotizing skin disease that primarily affects the subcutaneous fat tissue, leading to ulceration of the overlying dermal and epidermal layers of the skin [32]. The disease is reported from tropical regions worldwide, but has its highest prevalence in West Africa [33], (Figure 1). Three distinct non-ulcerative stages of the disease are described: (i) subcutaneous, painless and movable nodules or papules, (ii) edema, and (iii) plaques. All of them may progress to ulceration, once the destruction of the subcutis results in collapse of the overlying epidermis and dermis [32]. The majority of BU patients have a single skin lesion located at the upper or lower extremities, but all body surfaces can be affected [32]. Mycobacterium ulcerans has a low optimal growth temperature of 30–33 °C [34,35] and this temperature preference is considered a major factor for the explicit skin tropism and the limited systemic dissemination of M. ulcerans infections [36].
State-of-the-art treatment strategies for nontuberculous mycobacteria infections
Published in Expert Opinion on Pharmacotherapy, 2020
Maria-Carmen Muñoz-Egea, Nerea Carrasco-Antón, Jaime Esteban
Buruli ulcer is caused by M. ulcerans. Surgery still remains crucial for the cure of this condition in severe ulcers [53], although the combination of rifampin and a quinolone or clarithromycin for 8 weeks has shown promising results [71].
Reconstructive surgery for sequellae of Mycobacterium ulcerans infection (Buruli ulcer) of the upper limb
Published in Journal of Plastic Surgery and Hand Surgery, 2021
W. M. Calonge, P. Meredith, K. A. Kouakou-Adonis, C. K. Yao, K. M. N’da Assie, H. Asse
Buruli ulcer (BU), is a necrotizing skin condition caused by Mycobacterium ulcerans.It is the third most common mycobacterial infection worldwide, though in some areas its prevalence seems to have overrun those of tuberculosis and leprosy [1–3].