Buruli Ulcer

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Overview

Buruli ulcer (BU), caused by Mycobacterium ulcerans, is an indolent necrotizing infection of the skin, subcutaneous tissue, and bone. Synonyms for BU are Bairnsdale or Searles’ ulcer in Australia, and Kumusi ulcer in Papua New Guinea. Dodge and Lunn named the disease in 1962 after the geographic site of the first large epidemic investigated, in Buruli County, Uganda, now Nakasongola District.1 Cook described the disease in 1897 in Uganda.2 Because BU appears in forms other than ulcers, many investigators prefer the term M. ulcerans disease. BU is the third most common mycobacterial infection of humans, after tuberculosis and leprosy. The World Health Organization (WHO) in 1998 recognized BU as a re-emerging infection, most pronounced in West Africa, where the disease is a major public health problem because of frequent disabling and stigmatizing complications.

Symptoms

The symptoms of Buruli ulcer include:


Swelling of the skin

Destroyed skin and soft tissue

One or more slow growing, generally painless ulcers

People who are sick should see a doctor and get antibiotics (medicine that can help stop the disease).


If these antibiotics are not given soon after getting sick, the disease can sometimes lead to:


Deformity

Functional disability (such as limited joint movement)

Bone infection

Secondary bacterial infection of skin ulcer lesions

Causes

Buruli ulcer is a disease caused by the bacterium Mycobacterium ulcerans. It mainly affects the skin but can also affect the bone. Cases are generally seen in the tropics, primarily in West Africa and Australia. Infection often leads to ulcers on the arms or legs, which can also destroy skin or soft tissue.

Buruli ulcer, caused by Mycobacterium ulcerans, is a chronic debilitating disease that affects mainly affects the skin and sometimes bone. The organism belongs to the family of bacteria that causes tuberculosis and leprosy, which provides an opportunity for collaboration with these disease programmes.

Risk factors

Buruli ulcer is caused by Mycobacterium ulcerans the bacteria that cause tuberculosis and leprosy . How it is transmitted is still being investigated but the risk factors include proximity to stagnant or slow-flowing bodies of water, poor wound care and not wearing protective clothing 

Mosquito bites and puncture wounds are likely to transmit the bacteria that cause Buruli ulcer, a disfiguring infectious disease in humans. Buruli ulcer spreads via mosquito bites and puncture wounds, researchers have found. This infectious disease is spreading in areas near Melbourne, Australia

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Complications

What are the complications of Buruli ulcer? Tissue destruction can be extensive (involving up to 15% of the patient's skin surface) and secondary infection may occur. Other complications include osteomyelitis (infection of the bone) and metastatic lesions (the spread of the wounds to distant sites).The World Health Organization (WHO) clinical case definition for Buruli ulcer divides the disease into two stages: active and inactive. The active form is characterized by non-ulcerative (papules, nodules, plaques, and edema) and ulcerative disease.


Prevention

Although the exact cause of infection in humans is not known, it makes sense to protect yourself from potential sources of infection such as soil and insect bites.


Suggestions to reduce the risk of infection include:


Wear gardening gloves, long-sleeved shirts and trousers when working outdoors.

Avoid insect bites by using suitable insect repellents.

Protect cuts or abrasions with sticking plasters.

Promptly wash and cover any scratches or cuts you receive while working outdoors.

See your doctor if you have a slow-healing skin lesion.

It is important to remember that the risk of infection is low, even in those areas where the infection is endemic (constantly present in the community).