Buruli

Question 1

Key characteristics of Buruli Ulcer?

Answer 1

Undetermined border
Painless

Question 2

Where is it mainly found?

Answer 2

Central and West africa, mainly Ivory Coast
Australia

Question 3

How do you get Buruli?

Answer 3

Typically swamps, creeks
It is environmental spread mycobacteria

Question 4

Risk factors?

Answer 4

Water sources
Age <15yrs
Genetic susceptibility
Typically from rice farms

Question 5

What is pathogenesis?

Answer 5

Mycobacteriam Ulcerans is the organsim
Ctyotoxicity, Immunosuppression and analgesia explain why Painless

Question 6

How does Buruli look?

Answer 6

Primary lesion initially a nodule evolving into an abscess into an ulcer
Undermined borders
Can have bone involvement

Question 7

How do you diagnose Buruli?

Answer 7

Direct exam
PCR now preferred method
Serology
Biopsy

Question 8

What is seen on punch biopsy?

Answer 8

Huge amount of necrosis and AFB seen

Question 9

How do you differentiate with leishmania?

Answer 9

Not the same amount of necrosis as seen in Buruli and Borders very different

Question 10

How do you treat Buruli?

Answer 10

Oral therapies preferred
Combination of rifampicin and clarithromycin now preferred