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.