BURULI ULCER / MedUrgent

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 ِBURULI ULCER

 This is a chronic type of ulcers that is commonly seen in Uganda (Buruli County area), Sudan, West Africa, New Guinea, South East Asia, South America and Australia. The disease is caused by Mycobacterium ulcerans and transmitted via aquatic areas.

Pathogenesis

It starts as a painless subcutaneous nodule in any part of the body especially exposed areas. Infection of the subcutaneous fat leads to skin ulceration due to the toxin produced by the Mycobacterium ulcerans. In severe forms or super-infected ulcers, there is pain and fever. Ulceration heals by granulation leading to scarring and contractures.






Investigations

- Culture of a swab 

- Ziehl-Neelsen stain

- PCR

Treatment

- Rifampicin+ Streptomycin for 8 weeks (or clarithromycin)

- Surgical excision

- Local heat at 40 C

Prevention

- BCG vaccination

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