Buruli Ulcer Transmission: Environmental Pathways and Implications for Dermatologic Care

Abstract

Buruli ulcer (BU) is a necrotizing skin and soft tissue disease caused by Mycobacterium ulcerans that is common in hot and humid climates. Mycobacterium ulcerans is a nontuberculous mycobacterium and ubiquitous acid-fast gram-positive bacillus known to thrive in aquatic environments and water insects. The mode of transmission to humans is poorly understood and varies by geography. Aquatic insects and mosquitoes have been studied as possible vectors for the transmission of M ulcerans and the development of BUs. Treatment involves a long course of antibiotics with possible surgical debridement with wide margins for extensive ulceration. In this article, we provide an overview of the etiology, pathogenesis, transmission, clinical presentation, prevention, and treatment of BUs.