MD, BParaSci, GradCertClinEd, Infectious Disease Registrar, Victorian Infectious Disease Service, The Royal Melbourne Hospital, Melbourne, Vic.
BSc, BMedSc, MBBS, MPHTM, MClinEd, FACTM, FFTM, FRACP, Infectious Diseases Physician, Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Melbourne, Vic; Department of Microbiology and Immunology, University of Melbourne, Melbourne, Vic.
Aust J Gen Pract. 2024 Sep;53(9):671-674. doi: 10.31128/AJGP-08-23-6914.
Buruli ulcer (BU) is caused by Mycobacterium ulcerans, an environmental pathogen that causes severe skin and soft-tissue necrosis. In Australia, cases of BU are acquired in endemic regions, which include Victoria and Far North Queensland, but those who have visited these regions can present to health practitioners anywhere.
This article provides Australian general practitioners with an overview of BU, including its epidemiology, transmission, clinical features, diagnosis and management.
BU can manifest as an ulcer or as a non-ulcerated skin lesion, such as a plaque, nodule or oedema. Diagnosis can be achieved with a dedicated Mycobacterium ulcerans polymerase chain reaction (PCR) test performed on a wound swab. Swabs on non-ulcerated disease have a high false negative rate, and a PCR test should be performed on a tissue biopsy to confirm disease. Most cases are managed with prolonged antibiotic therapy - commonly a combination of oral rifampicin and clarithromycin or fluroquinolone (moxifloxacin or ciprofloxacin) - and wound dressings.
溃疡分枝杆菌引起的皮肤和软组织坏死性疾病，即崩漏溃疡（BU）。在澳大利亚，BU 主要发生于维多利亚州和昆士兰州北部等流行地区，但是曾经到过这些地区的人也可能会在任何地方发病。
本文为澳大利亚全科医生提供崩漏溃疡的概述，包括流行病学、传播途径、临床特征、诊断和管理。
BU 可表现为溃疡或无溃疡皮肤损伤，如斑块、结节或水肿。通过对伤口拭子进行特定的溃疡分枝杆菌聚合酶链反应（PCR）检测可以确诊。非溃疡性疾病的拭子假阴性率较高，因此应该对组织活检进行 PCR 检测以确认疾病。大多数病例采用长期抗生素治疗，通常是口服利福平联合克拉霉素或氟喹诺酮类（莫西沙星或环丙沙星）和伤口敷料。
