Dega H, Chosidow O, Barete S, Carbonnelle B, Grosset J, Jarlier V
Service de Bactériologie-Hygiène, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Ann Med Interne (Paris). 2000 Sep;151(5):339-44.
Mycobacterium ulcerans infection, or Buruli ulcer, is the third most common mycobacterial disease of the immunocompetent host in the tropical areas. M. ulcerans reservoir is aquatic. Infection occurs in children and young adults. The lesion begins with an indolent subcutaneous nodule, principally located on the limbs, that progressively changes into a deep indolent extensive ulcer. M. ulcerans produces a lipidic necrotic and immunosuppressive toxin, named mycolactone, that causes the clinical lesions. In endemic areas, clinical diagnosis is confirmed by microscopic examination. Spontaneous healing occurs after several months or years, causing retractile scars. Surgical excision and grafting is the treatment of choice. Antibiotic therapy is of limited value.
溃疡分枝杆菌感染，即布鲁里溃疡，是热带地区免疫功能正常宿主中第三常见的分枝杆菌病。溃疡分枝杆菌的储存宿主是水生生物。感染发生在儿童和年轻人中。病变始于一个无痛性皮下结节，主要位于四肢，逐渐发展成一个深部无痛性广泛溃疡。溃疡分枝杆菌产生一种名为分枝杆菌内酯的脂质坏死和免疫抑制毒素，可导致临床病变。在流行地区，通过显微镜检查可确诊临床诊断。数月或数年后会自发愈合，留下挛缩性瘢痕。手术切除和植皮是首选治疗方法。抗生素治疗价值有限。
