Mycobacterium ulcerans infection

Mycobacterium ulcerans is the causative agent of a new emerging infectious disease, which has been reported in at least 33 countries worldwide with tropical, subtropical and temperate climates. Classified by the WHO as one of the 17 neglected tropical diseases, M. ulcerans infection is the third most common mycobacterial disease in the world, after tuberculosis and leprosy. In East Africa, where it is endemic and thousands of cases are observed annually, the infection is the second most important mycobacterial disease after tuberculosis. Buruli ulcer disease (the name adopted for this infection worldwide) is often referred to as the “mysterious disease” because the mode of transmission remains unclear, although several hypotheses have been proposed. It is a serious necrotizing infection due to a toxin, mycolactone, produced by the bacilli, that necrotizes the subcutaneous tissue leading to deep ulceration. This is the most severe form of the disease. Early detection before ulceration is therefore the key to prompt cure; otherwise, if diagnosed late, the infection may leave patients with disabling sequelae, such as scarring contractures and possible bone destruction requiring amputation.