Chapter 12 : Understanding Buruli Ulcer Disease)

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Buruli ulcer is a destructive infection of skin and soft tissue caused by , a toxin-producing environmental mycobacterium. is unique among human pathogens in its capacity to produce mycolactones, a family of closely related diffusible accessory molecules that are essential for virulence and are likely to confer important survival advantages in its as yet unknown environmental niche. The first description of mycolactones was published in 1999, with the identification of mycolactone A/B isomers in lipid extracts from an archived Malaysian strain of , MU1615. This landmark paper also reported the demonstration of the important role of mycolactones in the virulence of . The activity of mycolactone on human cells strongly suggests that bacterial production of mycolactone in vivo favors the establishment of long-term infections by suppressing host immune defenses. Between 1998 and 2003, at least 11 cases of disease were identified in a second species of arboreal mammal, the common ringtail possum (). All-oral antibiotic combinations have recently been shown capable of rendering excision specimens culture negative at the time of excision in a small case series, and rifampin with clarithromycin has been used successfully in a young pregnant woman in Africa for whom streptomycin was contraindicated.

Citation: Johnson P, Demangel C, Stinear T, Benbow M, Fyfe J. 2010. Understanding Buruli Ulcer Disease), p 241-260. In Scheld W, Grayson M, Hughes J (ed), Emerging Infections 9. ASM Press, Washington, DC. doi: 10.1128/9781555816803.ch12
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Mycolactone A (source: Wikipedia).

Citation: Johnson P, Demangel C, Stinear T, Benbow M, Fyfe J. 2010. Understanding Buruli Ulcer Disease), p 241-260. In Scheld W, Grayson M, Hughes J (ed), Emerging Infections 9. ASM Press, Washington, DC. doi: 10.1128/9781555816803.ch12
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