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Chapter 37 - Mycobacterium ulcerans Disease (Buruli Ulcer)

from Section 5 - Bacterial Infections

Published online by Cambridge University Press:  18 June 2025

David Mabey
Affiliation:
London School of Hygiene and Tropical Medicine
Martin W. Weber
Affiliation:
World Health Organization
Moffat Nyirenda
Affiliation:
London School of Hygiene and Tropical Medicine
Dorothy Yeboah-Manu
Affiliation:
Noguchi Memorial Institute for Medical Research, University of Ghana
Jackson Orem
Affiliation:
Uganda Cancer Institute, Kampala
Laura Benjamin
Affiliation:
University College London
Michael Marks
Affiliation:
London School of Hygiene and Tropical Medicine
Nicholas A. Feasey
Affiliation:
Liverpool School of Tropical Medicine
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Summary

Buruli ulcer (BU) caused by Mycobacterium ulcerans causes a severe necrotizing infection of the skin and subcutaneous tissues. It can sometimes extend to involve the underlying muscles and rarely affects bone resulting in osteomyelitis. The disease was first described by Sir Albert Cook during his pioneering work in Uganda in 1897. Subsequently, MacCallum and other Australian scientists coincidentally found the causative organism to be M. ulcerans when an incubator originally set at 37°C broke down. The name Buruli comes from an area of Uganda where many cases were reported in the 1960s. In 1998, the World Health Organization (WHO) established the Global Buruli Ulcer Initiative to coordinate control and research activities towards the elimination of BU and this has led to major gains in understanding the disease mechanism. Now, the WHO has designated the disease as a neglected tropical disease (NTD) (WHO 2024).

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