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Buruli Ulcer Buruli Ulcer Mycobacterium ulcerans Mycobacterium ulcerans Infection Infection Prepared by: A. Elkader Y. Elottol Supervisor: Prof M. Shubir

Buruli Ulcer Mycobacterium ulcerans Infection

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Buruli Ulcer Mycobacterium ulcerans Infection. Prepared by: A. Elkader Y. Elottol Supervisor: Prof M. Shubir. Disease caused by Mycobacterium ulcerans. First described by MacCallum in 1948, but the name came from Buruli country in Uganda. - PowerPoint PPT Presentation

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Page 1: Buruli Ulcer Mycobacterium ulcerans  Infection

Buruli UlcerBuruli UlcerMycobacterium ulceransMycobacterium ulcerans

InfectionInfection

Prepared by: A. Elkader Y. ElottolSupervisor: Prof M. Shubir

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Disease caused by Disease caused by Mycobacterium Mycobacterium ulcerans.ulcerans.First described by MacCallum in 1948, but First described by MacCallum in 1948, but the name came from Buruli country in the name came from Buruli country in Uganda.Uganda.The third most common Mycobacterium , The third most common Mycobacterium , that affected more than 30 countries .that affected more than 30 countries .

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Mode of transmissionMode of transmissionMode of transmission is not entirely Mode of transmission is not entirely known evidence suggest that insects known evidence suggest that insects are aquatic bugs belong to the genus are aquatic bugs belong to the genus Noucaris and DiplonychusNoucaris and Diplonychus may may transmit the microbe.transmit the microbe.Person to person transmission are Person to person transmission are not clearly supported .not clearly supported .Trauma during swimming. Trauma during swimming.

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PathogenesisPathogenesisOnce inoculated into the subcutaneous tissue Once inoculated into the subcutaneous tissue the organisms proliferates and elaborates a toxin the organisms proliferates and elaborates a toxin that has affinity for fat cells.that has affinity for fat cells.The toxin called The toxin called MycolactoneMycolactone which cause local which cause local immunosuppression in infected tissue.immunosuppression in infected tissue.The most affected are children under the age of The most affected are children under the age of 15 years, mortality is low but disability is 15 years, mortality is low but disability is high(66%) affected region mostly the upper high(66%) affected region mostly the upper extremities.extremities.The resulting necrosis then provides a favorable The resulting necrosis then provides a favorable milieu for further proliferation of the organisms.milieu for further proliferation of the organisms.Clinically the disease manifests as Papules, Clinically the disease manifests as Papules, Nodules, Plaques, Odematous Forms and Nodules, Plaques, Odematous Forms and Ulcers.Ulcers.

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Mycolactone toxin

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DiagnosisDiagnosis

Clinical: depending on the clinical groundClinical: depending on the clinical groundLaboratory: any two of the following finding are Laboratory: any two of the following finding are required:required:Acid fast bacilli in a smear stained with Ziehl Acid fast bacilli in a smear stained with Ziehl Neelsen .Neelsen .Positive culture of M.ulcerans ( Positive culture of M.ulcerans ( required 6-8 required 6-8 weeks or longer at 30-33ċ, produce Rough weeks or longer at 30-33ċ, produce Rough domed, lemon yellow colony on L.J mediumdomed, lemon yellow colony on L.J medium))Histopathological study of excisional biopsy Histopathological study of excisional biopsy specimen.specimen.Positive PCR for DNA from Positive PCR for DNA from M. ulceransM. ulcerans..

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PCR PCR

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TreatmentTreatmentDrug treatment: several antimicrobial Drug treatment: several antimicrobial agent have in vitro activity , but no single agent have in vitro activity , but no single agent has been proven to regularly useful agent has been proven to regularly useful in treatment.in treatment.Agent used include Rifampicin, Rifabutin, Agent used include Rifampicin, Rifabutin, Clarithromycin,Azithromycin,Streptomycin, Clarithromycin,Azithromycin,Streptomycin, and Amikacin.and Amikacin.Combination therapy are mostly used.Combination therapy are mostly used.Surgical treatment: need prolong hospital Surgical treatment: need prolong hospital stay (100 days).stay (100 days).

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PreventionPreventionNo available Vaccine, used BCG give immunity No available Vaccine, used BCG give immunity to about 47%.to about 47%.

ReferancesReferancesWorld HealthOrganization.World HealthOrganization.Center for Desease ControlCenter for Desease Control

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TANKS