Mycobacterium ulcerans infection: control, diagnosis, and treatment

Abstract

The skin disease Buruli ulcer, caused by Mycobacterium ulcerans, is the third most common mycobacterial disease after tuberculosis and leprosy and mainly affects remote rural African communities. Although the disease is known to be linked to contaminated water, the mode of transmission is not yet understood, which makes it difficult to propose control interventions. The disease is usually detected in its later stages, when it has caused substantial damage and disability. Surgery remains the treatment of choice. Although easy and effective in the early stages of the disease, treatment requires extended excisions and long hospitalisation for the advanced forms of the disease. Currently, no antibiotic treatment has proven effective for all forms of M ulcerans infection and research into a new vaccine is urgently needed. While the scientific community works on developing non-invasive and rapid diagnostic tools, the governments of endemic countries should implement active case finding and health education strategies in their affected communities to detect the disease in its early stages. We review the diagnosis, treatment, and control of Buruli ulcer and list priorities for research and development.

Suppressive effect of mycolactone-containing fraction from Mycobacterium ulcerans on antibody production against co-administered antigens

“…AT2R blockers inhibit Th 1 and Th 2 immune responses in mice [29,30]. Additionally, mycolactone affects RAW267.4, a macrophage-like mouse cell line, to cause hyperpolarization through AT2R signal inhibition [28].…”

“…Buruli ulcer is a necrotizing skin infection caused by Mycobacterium ulcerans [1][2][3]. The disease mainly prevails in West Africa, and its incidence is increasing in Asia, Australia, and Latin America [1][2][3].…”

“…The disease mainly prevails in West Africa, and its incidence is increasing in Asia, Australia, and Latin America [1][2][3]. The pathogenesis of Buruli ulcer depends on mycolactone, a lipid toxin produced by M. ulcerans [4].…”

Analysis of the Mycobacterium ulcerans genome sequence reveals new loci for variable number tandem repeats (VNTR) typing

“…Mycobacterium ulcerans, a slow-growing environmental mycobacterium (Yeboah-Manu et al, 2004), causes Buruli ulcer, which is, after tuberculosis and leprosy, the third most important mycobacterial disease worldwide (Sizaire et al, 2006;van der Werf et al, 2003). Buruli ulcer is mainly prevalent in West Africa but cases have also been reported from various other tropical and sub-tropical areas of the world (Asiedu et al, 2000;Johnson et al, 2005).…”

Mycobacterium ulceransDisease, Peru

“…data). The distribution of BU in Peru and elsewhere is strongly associated with wetlands, especially those with slow-fl owing or stagnant water (e.g., ponds, backwaters, and swamps) (4,5). All of our patients had contacts with swampy areas in the Amazon River Basin (5 patients) or on the northern coast (3 patients).…”