Johnson Paul D R, Hayman John A, Quek Tricia Y, Fyfe Janet A M, Jenkin Grant A, Buntine John A, Athan Eugene, Birrell Mike, Graham Justin, Lavender Caroline J
Department of Infectious Diseases, Austin Health, Melbourne, Victoria, Australia.
Med J Aust. 2007 Jan 15;186(2):64-8. doi: 10.5694/j.1326-5377.2007.tb00802.x.
Mycobacterium ulcerans causes slowly progressive, destructive skin and soft tissue infections, known as Bairnsdale or Buruli ulcer (BU). Forty-six delegates with experience in the management of BU attended a 1-day conference in Melbourne on 10 February 2006, with the aim of developing a consensus approach to the diagnosis, treatment and control of BU. An initial draft document was extended and improved during a facilitated round table discussion. BU is an environmental infection that occurs in specific locations. The main risk factor for infection is contact with an endemic area. Prompt cleaning of abrasions sustained outdoors, wearing protective clothing, and avoiding mosquito bites may reduce an individual's risk of infection. BU can be rapidly and accurately diagnosed by polymerase chain reaction testing of ulcer swabs or biopsies. Best outcomes are obtained when the diagnosis is made early. To aid early diagnosis, health authorities should keep local populations informed of new outbreaks. BU is best treated with surgical excision, which, if possible, should include a small rim of healthy tissue. For small lesions this may be all that is required. However, there is a role for antibiotics for more extensive disease, and their use may allow more conservative surgery.
溃疡分枝杆菌可引起缓慢进展的、具有破坏性的皮肤和软组织感染，即所谓的拜恩斯代尔溃疡或布鲁里溃疡（BU）。2006年2月10日，46名有布鲁里溃疡管理经验的代表参加了在墨尔本举行的为期一天的会议，目的是就布鲁里溃疡的诊断、治疗和控制形成一种共识方法。在一次有主持人的圆桌讨论中，一份初始文件草案得到了扩展和完善。布鲁里溃疡是一种发生在特定地点的环境感染。感染的主要危险因素是接触流行地区。及时清洗在户外受的擦伤、穿防护服以及避免蚊虫叮咬可能会降低个人的感染风险。通过对溃疡拭子或活检组织进行聚合酶链反应检测，可以快速准确地诊断布鲁里溃疡。早期诊断能取得最佳治疗效果。为帮助早期诊断，卫生当局应让当地居民了解新的疫情爆发情况。布鲁里溃疡最好采用手术切除治疗，如有可能，应包括一小圈健康组织。对于小病变，这可能就是所需的全部治疗手段。然而，对于更广泛的疾病，抗生素也有作用，使用抗生素可能允许采用更保守的手术方式。
