Buruli ulcer
A chronic debilitating skin and soft tissue infection
Buruli ulcer | |
---|---|
![]() | |
Synonyms | Bairnsdale ulcer, Daintree ulcer, Mossman ulcer, Kumasi ulcer, Searls ulcer |
Pronounce | N/A |
Field | Infectious disease |
Symptoms | Painless area of swelling under the skin, which becomes a necrotic ulcer |
Complications | Permanent disfigurement, secondary infections, restricted movement of limbs |
Onset | Gradual; may take weeks to months for ulcer to develop |
Duration | Weeks to months, depending on treatment |
Types | N/A |
Causes | Mycobacterium ulcerans |
Risks | Exposure to contaminated environments, especially in tropical and subtropical regions; proximity to wetlands |
Diagnosis | Clinical examination, PCR test, acid-fast bacilli smear, histopathology, culture |
Differential diagnosis | Cutaneous leishmaniasis, tropical ulcer, diabetic ulcer, pyoderma gangrenosum |
Prevention | Avoiding insect bites and contact with contaminated water in endemic areas; wound care |
Treatment | Combination antibiotic therapy with rifampicin and clarithromycin or streptomycin |
Medication | Rifampicin, clarithromycin, streptomycin |
Prognosis | Good with early treatment; delayed treatment may result in severe scarring and disability |
Frequency | Endemic in West and Central Africa, parts of Australia, and Southeast Asia |
Deaths | Rare with proper treatment, but can occur in severe untreated cases |
Buruli ulcer is a chronic, debilitating skin and soft tissue infection caused by the bacterium Mycobacterium ulcerans. It is characterized by the development of large ulcers, primarily on the limbs, and can lead to significant morbidity if not treated appropriately.
Epidemiology
Buruli ulcer is most commonly found in rural areas of West Africa, Central Africa, and some parts of Australia. It is considered a neglected tropical disease and primarily affects children and young adults. The exact mode of transmission is not well understood, but it is believed to be associated with environmental factors, particularly aquatic environments.
Pathophysiology
The disease is caused by Mycobacterium ulcerans, which produces a toxin known as mycolactone. This toxin is responsible for the tissue necrosis and immunosuppression observed in Buruli ulcer. The infection typically begins as a painless nodule or papule, which can progress to a large ulcer with undermined edges.
Clinical Presentation
The initial presentation of Buruli ulcer is often a painless, firm nodule or plaque. Over time, this lesion can ulcerate, leading to the characteristic large, necrotic ulcer with undermined edges. The ulcers are typically painless, but secondary bacterial infections can cause pain and further complications. The disease primarily affects the skin and soft tissues, but in severe cases, it can involve bones.
Diagnosis
Diagnosis of Buruli ulcer is primarily clinical, supported by laboratory tests. Polymerase chain reaction (PCR) testing for Mycobacterium ulcerans DNA is the most sensitive method. Other diagnostic methods include microscopy, culture, and histopathology. Early diagnosis is crucial for effective treatment and to prevent complications.
Treatment
The mainstay of treatment for Buruli ulcer is a combination of antibiotics, typically rifampicin and clarithromycin or streptomycin. Surgical intervention may be necessary for extensive lesions, including debridement and skin grafting. Early treatment is essential to prevent severe tissue damage and disability.
Prevention
Preventive measures for Buruli ulcer are not well established due to the unclear mode of transmission. However, efforts to reduce exposure to potential environmental sources, such as stagnant water, may help reduce the risk. Community education and early case detection are important components of prevention strategies.
Related pages
Transform your life with W8MD's budget GLP-1 injections from $125.
W8MD offers a medical weight loss program to lose weight in Philadelphia. Our physician-supervised medical weight loss provides:
- Most insurances accepted or discounted self-pay rates. We will obtain insurance prior authorizations if needed.
- Generic GLP1 weight loss injections from $125 for the starting dose.
- Also offer prescription weight loss medications including Phentermine, Qsymia, Diethylpropion, Contrave etc.
NYC weight loss doctor appointments
Start your NYC weight loss journey today at our NYC medical weight loss and Philadelphia medical weight loss clinics.
- Call 718-946-5500 to lose weight in NYC or for medical weight loss in Philadelphia 215-676-2334.
- Tags:NYC medical weight loss, Philadelphia lose weight Zepbound NYC, Budget GLP1 weight loss injections, Wegovy Philadelphia, Wegovy NYC, Philadelphia medical weight loss, Brookly weight loss and Wegovy NYC
WikiMD's Wellness Encyclopedia |
Let Food Be Thy Medicine Medicine Thy Food - Hippocrates |
Medical Disclaimer: WikiMD is not a substitute for professional medical advice. The information on WikiMD is provided as an information resource only, may be incorrect, outdated or misleading, and is not to be used or relied on for any diagnostic or treatment purposes. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition. WikiMD expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury, or liability whatsoever suffered as a result of your reliance on the information contained in this site. By visiting this site you agree to the foregoing terms and conditions, which may from time to time be changed or supplemented by WikiMD. If you do not agree to the foregoing terms and conditions, you should not enter or use this site. See full disclaimer.
Credits:Most images are courtesy of Wikimedia commons, and templates, categories Wikipedia, licensed under CC BY SA or similar.
Contributors: Prab R. Tumpati, MD