Buruli ulcer - Knowledge

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medicine—drives many to seek traditional healers for primary care. Traditional healers often treat Buruli ulcer with two simultaneous approaches: herbs and sometimes burning or bleeding to treat the physical wound; and confession, ritual purification, and prohibitions on food, interpersonal contact, or sex to treat the spiritual component of the disease. Those with Buruli ulcer report feeling shame and experiencing

3443: 857:. Papua New Guinea sporadically reports cases to the World Health Organization, typically less than a dozen per year. In the Americas, most Buruli ulcer is reported from French Guiana, with few cases described in surrounding countries. A 2019 review found "strong" evidence for the presence of Buruli ulcer in French Guiana and Peru, and "moderate" evidence in Brazil, Mexico and Suriname. 229:. With antibiotic administration and proper wound care, small ulcers typically heal within six months. Deep ulcers and those on sensitive body sites may require surgery to remove dead tissue or repair scarred muscles or joints. Even with proper treatment, Buruli ulcer can take months to heal. Regular cleaning and dressing of wounds aids healing and prevents secondary infections. 1052:. The introduction of antibiotics reduced the rate of ulcer recurrence to fewer than 2% of cases. However, streptomycin can be toxic to the ears and kidneys, and administering daily injections is challenging in low-resource settings. In 2017, the World Health Organization updated its recommendation to replace streptomycin with the oral antibiotic clarithromycin. 1027:

with the aim of coordinating global efforts to control the disease. This was followed in 2004 by World Health Organization Resolution WHA57.1 calling upon member countries to support the Global Buruli Ulcer Initiative and increase research on Buruli ulcer diagnostics and treatment. Interest in Buruli

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is occasionally found in these insects, and they can sometimes transmit the bacteria in laboratory settings. Whether these insects are regularly involved in transmission remains unclear. Pre-existing wounds have been implicated in disease transmission, and people who immediately wash and bandage open

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Over the course of a few weeks, the original swollen area expands to form an irregularly shaped patch of raised skin. After about four weeks, the affected skin sloughs off leaving a painless ulcer. Buruli ulcers typically have "undermined edges", the ulcer being a few centimeters wider underneath the

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of prevalence studies found a clear consensus that it is present in the Democratic Republic of the Congo, Gabon, Liberia, Nigeria, Togo, and South Sudan, as well as "strong" or "very strong" evidence of the disease in the Republic of the Congo, Sierra Leone, the Central African Republic, Guinea, and

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Cases of Buruli ulcer reported to the World Health Organization in 2018. Color indicates case number: yellow, (1–150) Dem. Rep. Congo, Gabon, Guinea, Togo; orange (151–300), Benin, Cameroon, Côte d'Ivoire; light red (301–450), Liberia, Nigeria; dark red (451+), Ghana. Not shown are Australia (358),

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Buruli ulcer can be prevented by avoiding contact with aquatic environments in endemic areas, although this may not be possible for people living in these areas. The risk of acquiring it can be reduced by wearing long sleeves and pants, using insect repellent, and cleaning and covering any wounds as

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classifies Buruli ulcer into three categories depending on the severity of its symptoms. Category I describes a single small ulcer that is less than 5 centimetres (2.0 inches). Category II describes a larger ulcer, up to 15 centimetres (5.9 in), as well as plaques and broader swollen areas that

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who saw the first Australian patients at the Bairnsdale Clinic and sent material to Peter MacCallum's group for further examination. The disease later became more generally known as "Bairnsdale ulcer" after the district where it was described. In northeastern Australia, north of Cairns, the disease

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communities, few characteristics predict who will acquire Buruli ulcer. Males and females are equally likely to be infected. Ulcers can appear in people of all ages, although infections are most common among children between 5 and 15 years in West Africa, and adults over 40 in Australia and Japan.

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Buruli ulcer is relatively rare, with 2,713 cases reported to the World Health Organization in 2018. Most countries do not report data on Buruli ulcer to the World Health Organization, and the extent of its spread is unknown. In many endemic countries, health systems likely do not record each case

776:, is more common in those with larger ulcers and ulcers on the trunk, and occurs more frequently in adults than in children. The paradoxical reaction in Buruli ulcer is thought to be due to the immune system responding to the wound as bacteria die and the immune-suppressing mycolactone dissipates. 779:

Small or medium-sized ulcers (WHO categories I and II) typically heal within six months of antibiotic treatment, whereas larger ulcers can take over two years to fully heal. Given the long healing times, wound care is a major part of treating Buruli ulcer. The World Health Organization recommends

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and coastal Australia, with occasional cases in Japan, Papua New Guinea and the Americas. In West Africa, the disease is predominantly reported from remote, rural communities in Benin, Côte d'Ivoire, Cameroon, and Ghana. Other countries in the region also have Buruli ulcer to some degree; a 2019

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suggested that the many antibiotic combinations being used are effective treatments, but there is insufficient evidence to determine if any combination is the most effective. Approximately 1 in 5 people with Buruli ulcer experience a temporary worsening of symptoms 3 to 12 weeks after they begin

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can only grow in relatively cool temperatures, mice are typically infected in furless parts of the body: the ear, tail, or footpad. After injection into the mouse, bacteria double every three to four days, and the first signs of skin disease appear after three to four weeks. This mouse model of

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Within affected countries, Buruli ulcer tends to occur in rural areas near slow-moving or stagnant water. In particular, the disease tends to appear near water that has experienced human intervention, such as the building of dams or irrigation systems, flooding, or deforestation. Within endemic

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From the time the disease was described, Buruli ulcer was treated with surgery to remove all affected tissue, followed by prolonged wound care. This treatment regimen was expensive, sometimes disfiguring, and often ineffective, ulcers recurring in up to a third of cases. Treatment dramatically

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The first sign of Buruli ulcer is a painless swollen bump on the arm or leg, often similar in appearance to an insect bite. Sometimes the swollen area instead appears as a patch of firm, raised skin about three centimeters across called a "plaque"; or a more widespread swelling under the skin.

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In endemic areas, particularly rural communities in Africa, people may be aware of Buruli ulcer's association with the environment, yet simultaneously associate it with witchcraft or other supernatural causes. This dual understanding of disease—combined with poor access to conventional

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can be grown in laboratory media, but its extremely slow growth rate prevents this from being used diagnostically; even under optimal growth conditions, the bacteria must grow for 9 to 12 weeks before they can be easily detected and identified. Another method of diagnosis is to take a

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healthy skin over the wound, or removing scar tissue that can deform muscles and joints. Specialized wound dressings developed for non-infectious causes of ulcer are occasionally used for treating Buruli ulcer, but can be prohibitively expensive in low-resource settings.

637:. In wealthier healthcare settings, diagnosis is routinely based on PCR results. In low-resource settings, PCR is often unavailable, or can only be performed later at a centralized diagnostic laboratory. For microscopy, fluid is typically taken from the ulcer's edge by 300:

Buruli ulcers can appear anywhere on the body, but are typically on the limbs. Ulcers are most common on the lower limbs (roughly 62% of ulcers globally) and upper limbs (24%), but can also be found on the trunk (9%), head or neck (3%), or genitals (less than 1%).

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standard wound care practices: covering the ulcer to keep it moist and protected from further damage; regularly changing wound dressings to keep the ulcer clean, removing excess fluid, and helping prevent infection. Treatment sometimes includes

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Buruli ulcer has primarily been used to test antibiotics. The antibiotic combinations, dose frequencies, and treatment durations currently in use were first tested in laboratory-infected mice. Some vaccine platforms have been tested in

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involved in immunity and wound healing. Broader studies have focused on genes involved in susceptibility to other mycobacterial infections, finding susceptibility to Buruli ulcer may be linked to variants in six immunity-related genes:

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have not yet opened into ulcers. Category III is for an ulcer larger than 15 centimeters, multiple ulcers, or ulcers that have spread to include particularly sensitive sites such as the eyes, bones, joints, or genitals.

904:, with lesions typically on the face, limbs, and tail. Ulcers have also been reported on domesticated animals, namely dogs, horses, alpacas, and a cat. In laboratories several species of animals have been infected with 164:

characterized by the development of painless open wounds. The disease is limited to certain areas of the world, most cases occurring in Sub-Saharan Africa and Australia. The first sign of infection is a small painless

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In 2018, WHO received 2,713 reports of Buruli ulcer globally. Although rare, it typically occurs in rural areas near slow-moving or stagnant water. The first written description of the disease is credited to

1016:, isolated the causative mycobacterium, and showed it could cause ulcers in laboratory rats. Over the following decades, more cases were described in Africa. A particularly high prevalence in Uganda's 605:

As Buruli ulcer most commonly occurs in low-resource settings, treatment is often initiated by a clinician based on signs and symptoms alone. Where available, diagnosis may then be confirmed by

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was introduced to humans although research in Australia indicates the possum as a vector along with mosquitoes to be the cause. Buruli ulcer does not spread from one person to another. In areas

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wounds are less likely to acquire Buruli ulcer. Wearing pants and long-sleeved shirts is associated with a lower risk of Buruli ulcer, possibly by preventing insect bites or protecting wounds.

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In some people, the ulcer may heal on its own or remain small but linger unhealed for years. In others, it continues to grow wider and sometimes deeper, with skin at the margin

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While Buruli ulcer is not contagious, susceptibility sometimes runs in families, suggesting genetics could play a role in who develops the disease. Severe Buruli ulcer in a

460:, aquatic insects, and other animals that live in or near water. A role for biting insects in transmission has been investigated, with particular focus on mosquitoes, 948:

Buruli ulcer is known by several other names in different parts of the world. In southeastern Australia, it was originally called "Searls' ulcer" after the physician

396:. This results in tissue death at the site of infection, causing the open ulcer characteristic of the disease. At the same time, Sec61 inhibition prevents cells from 3147:

van der Werf TS, Stienstra Y, Johnson RC, Phillips R, Adjei O, Fleischer B, Wansbrough-Jones MW, Johnson PD, Portaels F, van der Graaf WT, Asiedu K (October 2005).

853:). It is more rarely reported from Japan, Papua New Guinea, and the Americas. Japan reports a few locally acquired cases per year scattered across the main island, 1124:

used in laboratories are less standardized than the mice they infect; different laboratories use different strains based on convenience and accessibility. Three

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is transmitted from the environment to humans is not known, but may involve the bite of an aquatic insect or the infection of open wounds. Once in the skin,

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Other ulcerative diseases can appear similar to Buruli ulcer at its various stages. The nodule that appears early in the disease can resemble a bug bite,

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in Uganda, Cook noted several patients with slow-healing ulcers. The cause of these slow-healing ulcers was identified 50 years later in 1948, when

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is transmitted to humans remains unclear, but somehow bacteria enter the skin and begin to grow. Ulceration is primarily caused by the bacterial toxin

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and exposing muscle, tendon, and bone to the air. When ulcers extend into muscles and tendons, parts of these tissues can be replaced by scar tissue,

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Early signs of Buruli ulcer in Cameroon. Top, painless swollen bumps. Bottom-left, a "plaque". Bottom-right, widespread swelling of the lower arm.

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to kill the bacteria, and wound care or surgery to support the healing of the ulcer. The most widely used antibiotic regimen is once daily oral

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which infects aquatic animals and, rarely, humans. It is more distantly related to other slow-growing mycobacteria that infect humans, such as

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stains. This requires more invasive sampling and review by a trained pathologist, and is rarely used in places where Buruli ulcer is endemic.

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Buruli ulcer lesions. Top-left, an early ulcer. Top-right, a larger ulcer across the lower arm and wrist. Bottom, a large ulcer on the thigh.

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infection can cause Buruli ulcer-like lesions in some non-human animals. Natural non-human infections have only been described in coastal

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O'Brien D, Jenkin G, Buntine J, Steffen CM, McDonald A, Horne S, Friedman ND, Athan E, Huges A, Callan PP, Johnson PD (March 2014).

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in 1948, and the demonstration that the bacteria could cause ulcers in laboratory animals. While several animals are susceptible to

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Simpson H, Deribe K, Tabah EN, Peters A, Maman I, Frimpong M, Ampadu E, Phillips R, Sanderson P, Pullan RL, Cano J (July 2019).

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due to insufficient reach and resources, and so the reported numbers probably underestimate the true prevalence of the disease.

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is widespread in these environments, where it can survive as free-living or in association with other aquatic organisms. Live

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improved in 2004, when the World Health Organization recommended an eight-week course of daily oral rifampicin and injected

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or area of swelling, typically on the arms or legs. The nodule grows larger over days to weeks, eventually forming an open

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Uganda. Buruli ulcer is regularly reported from Australia, where it occurs in coastal clusters—two in Queensland (near

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Working to overcome the global impact of neglected tropical diseases: First WHO report on neglected tropical diseases

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and resulting in permanent disability. Exposed ulcers can be infected by other bacteria, causing the wound to become

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typically given to children to protect against tuberculosis offers temporary partial protection from Buruli ulcer.

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Yotsu RR, Suzuki K, Simmonds RE, Bedimo R, Ablordey A, Yeboah-Manu D, Phillips R, Asiedu K (September 2018).

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for Buruli ulcer, disease occurs near stagnant bodies of water, leading to the long-standing hypothesis that

384:. When Sec61 is blocked, proteins that would normally enter the endoplasmic reticulum are mistargeted to the 4176: 4021: 3654: 2786: 4245: 4162: 4068: 4007: 3933: 1410:"Mosquitoes spread flesh-eating bacteria that causes Buruli ulcer from possums to humans, scientists say" 650: 372:. As the bacteria grow, they release mycolactone into the surrounding tissue. Mycolactone diffuses into 4255: 3722: 2592:

MacCallum P, Tolhurst JC, Buckle G, Sissons HA (January 1948). "A new mycobacterial infection in man".

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infections in Papua New Guinea: Correlation of clinical, histological, and microbiologic features".

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in Uganda. Fifty years later, the causative bacterium was isolated and identified by a group at the

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can be grown in laboratory media, although its slow growth makes it challenging to study. Bacteria

897: 4092: 4078: 3859: 3688: 3630: 2027: 1132:, Côte d'Ivoire in 1996; "Mu1615" from Malaysia in the 1960s; and "S1013" from Cameroon in 2010. 768: 698: 654: 642: 586: 1980: 1978: 4085: 4039: 3987: 3952: 3864: 3815: 3784: 3759: 638: 433: 322: 190: 94: 2928:"Mapping the global distribution of Buruli ulcer: a systematic review with evidence consensus" 4221: 4124: 3959: 1975: 921: 901: 869: 578: 502: 381: 336: 3885: 3849: 3827: 3679: 3646: 3619: 1572: 1017: 1013: 885: 773: 614: 352: 3217:

Yotsu RR, Murase C, Sugawara M, Suzuki K, Nakanaga K, Ishii N, Asiedu K (September 2015).

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Suzuki K, Luo Y, Miyamoto Y, Murase C, Mikami-Sugawara M, Yotsu RR, Ishii N (April 2019).

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The first written description of Buruli ulcer is credited to a British missionary doctor,

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Vincent QB, Belkadi A, Fayard C, Marion E, Adeye A, Ardant MF, et al. (April 2018).

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soon as they are noticed. There is no specific vaccine for preventing Buruli ulcer. The

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infection, and tissue death due to poor circulation. More diffuse lesions can resemble

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Couppié P, Blaizot R, Velvin CJ, Douine M, Combe M, Nacher M, Gozlan RE (April 2019).

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of the ulcer show a core of growing bacteria surrounded by debris from dead and dying

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strains are particularly common, each isolated from an infected person: "Cu001" from

833: 166: 65: 2687: 1510: 1508: 1506: 1504: 360:. Buruli ulcer typically occurs near slow-moving or stagnant bodies of water, where 4142: 3610: 3412: 3404: 3365: 3355: 3320: 3316: 3312: 3273: 3265: 3230: 3160: 3125: 3115: 3080: 3070: 3021: 2980: 2949: 2939: 2904: 2894: 2845: 2797: 2763: 2753: 2704: 2697:"Social Science Contributions to BU-Focused Health Service Research in West Africa" 2667: 2630: 2601: 2560: 2519: 2488: 2451: 2416: 2406: 2371: 2363: 2328: 2279: 2236: 2191: 1117: 913: 653:

diagnostic test. For many bacterial infections, the gold standard for diagnosis is

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infection. As of 2019, no vaccine tested completely protects mice from infection.

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Buruli ulcer has been the subject of scientific research since the description of

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that could affect their relationships, school attendance, and marriage prospects.

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mice) are most commonly used to model Buruli ulcer in modern laboratories. Since

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from a Buruli ulcer plaque lesion. In the left image, the tissue sample has been

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and sloughing off. Large ulcers may extend deep into underlying tissue, causing

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Meyers DH (July 2007). "Mycobacterium ulcerans infection: an eponymous ulcer".

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to coordinate global efforts to eliminate Buruli ulcer. WHO considers it a

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Bairnsdale ulcer, Daintree ulcer, Mossman ulcer, Kumasi ulcer, Searls ulcer

2787:"Laboratory Diagnosis of Buruli Ulcer: Challenges and Future Perspectives" 2463: 2074: 1823: 1477: 973: 448:

has been isolated from aquatic insects, mosses, and animal feces; and its

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or by swabbing the edge of the ulcer. The fluid is then stained with the

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is found in aquatic insects, mollusks, fish, and the water itself. How

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Tabah EN, Johnson CR, Degnonvi H, Pluschke G, Röltgen K (April 2019).

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along which villages with Buruli ulcer were originally described.

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led to the disease becoming more widely known as "Buruli ulcer".

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which makes mycobacteria visible. In practice microscopy detects

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on laboratory media can take up to three months to form visible

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in an attempt to model the course of Buruli ulcer. Injection of

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is called "Daintree ulcer" or "Mossman ulcer" after the nearby

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article, and later by both the World Health Organization and

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is somehow transmitted to humans from aquatic environments.

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Hotez PJ, Aksoy S, Brindley PJ, Kamhawi S (January 2020).

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in just 30–40% of infected people, making it a relatively

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examination. In the right image, it has been stained with

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Buruli ulcer is caused by infection of the skin with the

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Zingue D, Bouam A, Tian RB, Drancourt M (January 2018).

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Röltgen K, Cruz I, Ndung'u JM, Pluschke G (April 2019).

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infection (Buruli ulcer) in Australia: guideline update"

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Manry J (April 2020). "Human genetics of Buruli ulcer".

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can cause ulcers in several rodents (mice, guinea pigs,

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in 54–84% of infected people, and is highly specific to

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infection in French Guiana; current state of knowledge"

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in 1897. Cook was the first to describe Buruli ulcer.

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Disease (Buruli Ulcer): Guidance for Health Workers

2310: 1862: 1676: 1310: 1275: 1023:In 1998, the World Health Organization started the 140: 1460: 546:linked resistance to Buruli ulcer to a variant of 424:A riverine site in Ghana endemic for Buruli ulcer 3254:"Buruli Ulcer: a Review of the Current Knowledge" 2796:. Cham, Switzerland: Springer. pp. 183–202. 2703:. Cham, Switzerland: Springer. pp. 249–272. 2559:. Cham, Switzerland: Springer. pp. 227–239. 2444:American Journal of Tropical Medicine and Hygiene 2190:. Cham, Switzerland: Springer. pp. 159–181. 1170:"Buruli ulcer (Mycobacterium ulcerans infection)" 873:A common ringtail possum with an ulcer caused by 731:Buruli ulcer is treated through a combination of 4237: 2979:. Cham, Switzerland: Springer. pp. 87–105. 2550: 2311:Demangel C, Stinear TP, Cole ST (January 2009). 1649: 1269: 1028:ulcer has been encouraged by its branding as a " 3295:Yotsu RR, Richardson M, Ishii M (August 2018). 3020:. Cham, Switzerland: Springer. pp. 43–60. 2876: 2835: 2518:. Cham, Switzerland: Springer. pp. 61–76. 2470: 2395:"What constitutes a neglected tropical disease" 2278:. Cham, Switzerland: Springer. pp. 77–85. 2002:. World Health Organization. 2010. p. 62. 1887: 1454: 1396: 1254: 2844:. Cham, Switzerland: Springer. pp. 1–41. 613:DNA or microscopy to detect mycobacteria. The 184:Buruli ulcer is caused by skin infection with 3574: 2553:"Secondary infection of Buruli ulcer lesions" 685:, other mycobacterial skin infections, or an 3018:Buruli ulcer: Mycobacterium ulcerans disease 2977:Buruli ulcer: Mycobacterium ulcerans disease 2842:Buruli ulcer: Mycobacterium ulcerans disease 2794:Buruli ulcer: Mycobacterium ulcerans disease 2701:Buruli ulcer: Mycobacterium ulcerans disease 2557:Buruli ulcer: Mycobacterium ulcerans disease 2516:Buruli ulcer: Mycobacterium ulcerans disease 2481:International Journal of Infectious Diseases 2276:Buruli ulcer: Mycobacterium ulcerans disease 2188:Buruli ulcer: Mycobacterium ulcerans disease 772:taking antibiotics. This syndrome, called a 542:, as well as in two long non-coding RNAs. A 3342:Zimmerman P, Finn A, Curtis N (July 2018). 1571:. World Health Organization. Archived from 689:. Skin ulcers can resemble those caused by 485:family was attributed to a loss of 37 4251:Mycobacterium-related cutaneous conditions 3581: 3567: 2838:"Buruli ulcer: history and disease burden" 1172:. World Health Organization. 21 May 2019. 51: 3416: 3371:1983/67f9da43-e633-4b28-bb67-68d50f8117c4 3369: 3359: 3324: 3277: 3234: 3164: 3153:Bulletin of the World Health Organization 3129: 3119: 3084: 3074: 3025: 2984: 2953: 2943: 2908: 2898: 2849: 2801: 2767: 2757: 2708: 2564: 2523: 2492: 2437: 2420: 2410: 2375: 2332: 2283: 2240: 2195: 1923: 1561: 1164: 1162: 1160: 1158: 1156: 1154: 1152: 1150: 892:-positive lesions have been described in 476: 972: 868: 813: 718: 561: 419: 264: 3875:Extensively drug-resistant tuberculosis 3305:Cochrane Database of Systematic Reviews 3052: 2694: 2509: 2471:Jacobsen KH, Padgett JJ (August 2010). 2349: 2181: 2164: 2149: 2134: 2119: 2107: 2095: 1911: 1856: 1844: 1817: 1805: 1742: 1637: 1543: 1353: 1322: 1242: 14: 4238: 3661:Arcanobacterium haemolyticum infection 2657: 2551:Kpeli GS, Yeboah-Manu D (April 2019). 1868: 1147: 935: 924:, common brushtail possums, pigs, and 3562: 2620: 2594:Journal of Pathology and Bacteriology 2222: 2033:. World Health Organization. May 2004 1961:"Mengo Hospital medical notes – 1897" 1471: 1281: 1010:The Alfred Hospital's Baker Institute 819:Papua New Guinea (12) and Japan (3). 260: 181:, resulting in permanent disability. 2836:Röltgen K, Pluschke G (April 2019). 1176:from the original on 17 October 2019 1085:-infected mice, mostly based on the 670:from the ulcer and examine it under 173:. Deep ulcers can cause scarring of 3016:. In Pluschke G, Röltgen K (eds.). 2975:. In Pluschke G, Röltgen K (eds.). 2840:. In Pluschke G, Röltgen K (eds.). 2792:. In Pluschke G, Röltgen K (eds.). 2699:. In Pluschke G, Röltgen K (eds.). 2555:. In Pluschke G, Röltgen K (eds.). 2514:. In Pluschke G, Röltgen K (eds.). 2274:. In Pluschke G, Röltgen K (eds.). 2186:. In Pluschke G, Röltgen K (eds.). 1102:prolong the survival of mice after 711:and fungal infections of the skin. 119:2,713 cases reported to WHO in 2018 24: 3777:Tuberculous cervical lymphadenitis 3297:"Drugs for treating Buruli ulcer ( 3182:World Health Organization (2012). 2877:Röltgen K, Pluschke G (May 2020). 2672:10.5694/j.1326-5377.2007.tb01136.x 2069:Yotsu, Richardson & Ishii 2018 1617:Yotsu, Richardson & Ishii 2018 621:to detect a DNA sequence termed IS 550:associated with susceptibility to 25: 4267: 3870:Multi-drug-resistant tuberculosis 3590:Gram-positive bacterial infection 3435: 3258:Current Tropical Medicine Reports 1677:Zimmerman, Finn & Curtis 2018 1311:Demangel, Stinear & Cole 2009 1012:described a series of cases from 723:Healed Buruli ulcer lesions in a 82:Area of swelling that becomes an 3845:Primary inoculation tuberculosis 3441: 3149:"Mycobacterium ulcerans disease" 3108:PLOS Neglected Tropical Diseases 2746:The Medical Journal of Australia 2399:PLOS Neglected Tropical Diseases 2356:Journal of Clinical Microbiology 1041:PLOS Neglected Tropical Diseases 864: 827:Buruli ulcer is concentrated in 593:. The inset shows red-staining ( 130: 4197:Group JK corynebacterium sepsis 2020: 1990: 1987:, pp. 95–98, 103, 117–118. 1953: 1402: 809: 452:has been found in water, soil, 415: 412:(the most common immune cell). 376:cells and blocks the action of 249:. In 1998, WHO established the 3914:Borderline lepromatous leprosy 3904:Borderline tuberculoid leprosy 3811:Tuberculosis cutis orificialis 3348:Journal of Infectious Diseases 3317:10.1002/14651858.CD012118.pub2 2174: 1665:World Health Organization 2012 1188: 1025:Global Buruli Ulcer Initiative 251:Global Buruli Ulcer Initiative 13: 1: 3397:Clinical Microbiology Reviews 3195:. World Health Organization. 3063:Clinical Microbiology Reviews 2945:10.1016/S2214-109X(19)30171-8 2738:"Treatment and prevention of 2182:Bolz M, Ruf MT (April 2019). 1135: 796: 601:, suggestive of mycobacteria. 544:genome-wide association study 202:grows and releases the toxin 4177:Corynebacterium minutissimum 4022:Mycobacterium intracellulare 3655:Arcanobacterium haemolyticum 3121:10.1371/journal.pntd.0006429 2803:10.1007/978-3-030-11114-4_10 2710:10.1007/978-3-030-11114-4_15 2660:Medical Journal of Australia 2566:10.1007/978-3-030-11114-4_13 2412:10.1371/journal.pntd.0008001 1650:Kpeli & Yeboah-Manu 2019 1270:Kpeli & Yeboah-Manu 2019 1140: 845:) and two in Victoria (near 714: 557: 493:in a region that included a 278:skin than the wound itself. 7: 4163:Corynebacterium diphtheriae 3027:10.1007/978-3-030-11114-4_2 2986:10.1007/978-3-030-11114-4_5 2851:10.1007/978-3-030-11114-4_1 2525:10.1007/978-3-030-11114-4_3 2512:"Buruli ulcer in Australia" 2438:Igo JD, Murthy DP (1988). " 2321:Nature Reviews Microbiology 2285:10.1007/978-3-030-11114-4_4 2197:10.1007/978-3-030-11114-4_9 1888:Röltgen & Pluschke 2019 1455:Jacobsen & Padgett 2010 1397:Röltgen & Pluschke 2020 1255:Röltgen & Pluschke 2020 1068:ulcers, mice (particularly 1055: 589:, which helps to visualize 497:and was near the genes for 27:Infectious tropical disease 10: 4272: 3223:The Journal of Dermatology 3053:Tortoli E (October 2014). 2635:10.1007/s00439-020-02163-1 2494:10.1016/j.ijid.2009.11.013 2223:Bravo FG (November 2019). 1030:neglected tropical disease 968: 657:the infective organism in 454:mats of bacteria and algae 343:Mycobacterium tuberculosis 291:immobilizing the body part 255:neglected tropical disease 214:at the site of the ulcer. 4211: 4152: 4110: 4063: 3997: 3976: 3941: 3932: 3883: 3838:Papulonecrotic tuberculid 3772:Tuberculous lymphadenitis 3720: 3711: 3702: 3678: 3609: 3600: 3532: 3457: 3270:10.1007/s40475-018-0166-2 3219:"Revisiting Buruli Ulcer" 2887:Frontiers in Microbiology 2510:Johnson PD (April 2019). 2456:10.4269/ajtmh.1988.38.391 2242:10.1038/s41379-019-0399-1 888:, near Melbourne. There, 607:polymerase chain reaction 306:World Health Organization 219:World Health Organization 194:. The mechanism by which 115: 101: 89: 76: 64: 59: 50: 42: 37: 4191:Corynebacterium jeikeium 3855:Tuberculous pericarditis 3669:Actinomyces gerencseriae 3014:"Buruli ulcer in Africa" 2900:10.3389/fmicb.2020.01018 2695:Nichter M (April 2019). 2350:Guarner J (April 2018). 1948:van der Werf et al. 2005 1820:, pp. 160, 168–173. 1325:, p. 739, Figure 7. 902:common brushtail possums 312: 3860:Urogenital tuberculosis 3689:Propionibacterium acnes 3631:Cutaneous actinomycosis 3236:10.1111/1346-8138.13049 2973:"Buruli ulcer in Japan" 2606:10.1002/path.1700600111 1963:. British Library. 2017 898:common ringtail possums 788:necrotic ulcer tissue, 699:squamous cell carcinoma 3865:Tuberculous dactylitis 3816:Tuberculous cellulitis 3391:Mycobacterium ulcerans 3299:Mycobacterium ulcerans 3187:Mycobacterium ulcerans 2881:Mycobacterium ulcerans 2740:Mycobacterium ulcerans 2475:Mycobacterium ulcerans 2440:Mycobacterium ulcerans 2315:Mycobacterium ulcerans 2270:Mycobacterium ulcerans 1197:, eighth edition, 2020 985: 922:nine-banded armadillos 878: 820: 739:plus twice daily oral 728: 639:fine-needle aspiration 629:. This method detects 602: 503:antimicrobial peptides 477:Genetic susceptibility 425: 323:Mycobacterium ulcerans 270: 191:Mycobacterium ulcerans 95:Mycobacterium ulcerans 4222:Gardnerella vaginalis 4125:Nocardia brasiliensis 3361:10.1093/infdis/jiy207 2769:10536/DRO/DU:30086596 1985:MacCallum et al. 1948 1924:Igo & Murthy 1988 1721:, pp. 1033–1034. 1706:, pp. e917–e918. 1691:, pp. e912–e913. 1457:, pp. e678–e679. 976: 872: 817: 722: 655:isolating and growing 581:, a common stain for 579:hematoxylin and eosin 565: 428:It was not known how 423: 382:endoplasmic reticulum 337:Mycobacterium marinum 334:, closely related to 268: 3828:Lichen scrofulosorum 3680:Propionibacteriaceae 3620:Actinomyces israelii 3450:at Wikimedia Commons 3409:10.1128/CMR.00045-17 3076:10.1128/CMR.00035-14 2932:Lancet Global Health 2368:10.1128/JCM.01507-17 2235:(Suppl 1): 118–127. 1195:Macquarie Dictionary 1014:Bairnsdale, Victoria 784:to speed healing by 774:paradoxical reaction 353:Mycobacterium leprae 4121:Nocardia asteroides 4016:Mycobacterium avium 3919:Lepromatous leprosy 3899:Tuberculoid leprosy 3640:Tropheryma whipplei 2759:10.5694/mja13.11331 2334:10.1038/nrmicro2077 2167:, pp. 162–163. 2165:Bolz & Ruf 2019 2150:Bolz & Ruf 2019 2137:, pp. 166–167. 2135:Bolz & Ruf 2019 2120:Bolz & Ruf 2019 2110:, pp. 163–165. 2108:Bolz & Ruf 2019 2098:, pp. 160–161. 2096:Bolz & Ruf 2019 1900:O'Brien et al. 2014 1859:, pp. 256–258. 1818:Bolz & Ruf 2019 1806:Bolz & Ruf 2019 1791:Simpson et al. 2019 1779:Couppié et al. 2019 1704:Simpson et al. 2019 1689:Simpson et al. 2019 1679:, pp. 682–684. 1652:, pp. 235–236. 1607:, pp. 251–252. 1558:, pp. 189–190. 1556:Röltgen et al. 2019 1529:, pp. 186–187. 1527:Röltgen et al. 2019 1517:, pp. 185–186. 1515:Röltgen et al. 2019 1498:, pp. 190–191. 1496:Röltgen et al. 2019 1484:Vincent et al. 2018 1368:, pp. 247–248. 1272:, pp. 227–228. 1091:strain used in the 1088:Mycobacterium bovis 1032:", first in a 2005 1004:, Glen Buckle, and 936:Society and culture 920:), larger mammals ( 918:common African rats 704:Haemophilus ducreyi 687:enlarged lymph node 643:Ziehl–Neelsen stain 587:Ziehl–Neelsen stain 495:long non-coding RNA 406:tissue examinations 4246:Bacterial diseases 4213:Bifidobacteriaceae 4154:Corynebacteriaceae 4129:Nocardia farcinica 3966:Aquarium granuloma 3909:Borderline leprosy 3796:Erythema induratum 3533:External resources 2473:"Risk factors for 1936:Zingue et al. 2018 1755:Suzuki et al. 2019 1299:Zingue et al. 2018 986: 926:Cynomolgus monkeys 879: 821: 729: 625:that is unique to 603: 426: 271: 261:Signs and symptoms 235:Albert Ruskin Cook 212:immune suppression 162:infectious disease 71:Infectious disease 4256:Tropical diseases 4231: 4230: 4207: 4206: 4106: 4105: 4102: 4101: 3821:Tuberculous gumma 3704:Corynebacterineae 3698: 3697: 3647:Whipple's disease 3556: 3555: 3446:Media related to 3229:(11): 1033–1041. 3202:978-92-4-150340-2 3037:978-3-030-11114-4 2996:978-3-030-11114-4 2861:978-3-030-11114-4 2813:978-3-030-11114-4 2720:978-3-030-11114-4 2576:978-3-030-11114-4 2535:978-3-030-11114-4 2295:978-3-030-11114-4 2207:978-3-030-11114-4 2081:Tabah et al. 2019 2052:Hotez et al. 2020 2009:978-92-4-156409-0 1833:Tabah et al. 2019 1781:, pp. 77–78. 1767:Yotsu et al. 2018 1757:, pp. 87–88. 1745:, pp. 62–63. 1733:, pp. 51–54. 1731:Tabah et al. 2019 1719:Yotsu et al. 2015 1605:Yotsu et al. 2018 1440:Yotsu et al. 2018 1416:. 24 January 2024 1385:Yotsu et al. 2018 1366:Yotsu et al. 2018 1301:, pp. 10–13. 1212:Yotsu et al. 2015 914:greater cane rats 834:systematic review 491:chromosome 8 123: 122: 32:Medical condition 16:(Redirected from 4263: 4143:Rhodococcus equi 3939: 3938: 3806:Prosector's wart 3718: 3717: 3713:Mycobacteriaceae 3709: 3708: 3611:Actinomycetaceae 3607: 3606: 3583: 3576: 3569: 3560: 3559: 3455: 3454: 3445: 3430: 3420: 3383: 3373: 3363: 3338: 3328: 3291: 3281: 3248: 3238: 3213: 3211: 3209: 3194: 3178: 3168: 3143: 3133: 3123: 3098: 3088: 3078: 3049: 3029: 3008: 2988: 2967: 2957: 2947: 2938:(7): e912–e922. 2922: 2912: 2902: 2873: 2853: 2832: 2830: 2828: 2805: 2791: 2781: 2771: 2761: 2732: 2712: 2691: 2654: 2629:(6–7): 847–853. 2617: 2588: 2568: 2547: 2527: 2506: 2496: 2487:(8): e677–e681. 2467: 2434: 2424: 2414: 2389: 2379: 2362:(4): e01507–17. 2346: 2336: 2307: 2287: 2262: 2244: 2229:Modern Pathology 2219: 2199: 2168: 2162: 2153: 2147: 2138: 2132: 2123: 2117: 2111: 2105: 2099: 2093: 2084: 2078: 2072: 2066: 2055: 2049: 2043: 2042: 2040: 2038: 2032: 2024: 2018: 2017: 2012:. Archived from 1994: 1988: 1982: 1973: 1972: 1970: 1968: 1957: 1951: 1945: 1939: 1933: 1927: 1921: 1915: 1909: 1903: 1897: 1891: 1885: 1872: 1866: 1860: 1854: 1848: 1842: 1836: 1830: 1821: 1815: 1809: 1803: 1794: 1793:, pp. e918. 1788: 1782: 1776: 1770: 1764: 1758: 1752: 1746: 1740: 1734: 1728: 1722: 1716: 1707: 1701: 1692: 1686: 1680: 1674: 1668: 1662: 1653: 1647: 1641: 1635: 1620: 1614: 1608: 1602: 1585: 1584: 1582: 1580: 1565: 1559: 1553: 1547: 1541: 1530: 1524: 1518: 1512: 1499: 1493: 1487: 1486:, pp. 1–17. 1481: 1475: 1469: 1458: 1452: 1443: 1437: 1426: 1425: 1423: 1421: 1406: 1400: 1394: 1388: 1382: 1369: 1363: 1357: 1351: 1326: 1320: 1314: 1308: 1302: 1296: 1285: 1279: 1273: 1267: 1258: 1252: 1246: 1240: 1215: 1209: 1198: 1192: 1186: 1185: 1183: 1181: 1166: 1007: 957:and the town of 951: 659:laboratory media 609:(PCR) to detect 567:Photomicrographs 462:giant water bugs 400:to activate the 196:M. ulcerans 159: 158: 155: 154: 151: 148: 145: 142: 139: 136: 55: 35: 34: 21: 4271: 4270: 4266: 4265: 4264: 4262: 4261: 4260: 4236: 4235: 4232: 4227: 4203: 4148: 4098: 4059: 3993: 3972: 3928: 3924:Histoid leprosy 3879: 3726: 3723:M. tuberculosis 3694: 3674: 3596: 3587: 3557: 3552: 3551: 3528: 3527: 3466: 3438: 3433: 3403:(1): e0004–17. 3311:(8): CD012118. 3207: 3205: 3203: 3192: 3159:(10): 785–791. 3114:(4): e0006429. 3038: 2997: 2862: 2826: 2824: 2814: 2789: 2721: 2577: 2536: 2405:(1): e0008001. 2296: 2208: 2177: 2172: 2171: 2163: 2156: 2148: 2141: 2133: 2126: 2118: 2114: 2106: 2102: 2094: 2087: 2079: 2075: 2071:, pp. 6–7. 2067: 2058: 2054:, pp. 1–3. 2050: 2046: 2036: 2034: 2030: 2026: 2025: 2021: 2016:on 26 May 2017. 2010: 1996: 1995: 1991: 1983: 1976: 1966: 1964: 1959: 1958: 1954: 1946: 1942: 1938:, pp. 4–8. 1934: 1930: 1922: 1918: 1910: 1906: 1898: 1894: 1890:, pp. 1–2. 1886: 1875: 1867: 1863: 1855: 1851: 1843: 1839: 1831: 1824: 1816: 1812: 1804: 1797: 1789: 1785: 1777: 1773: 1765: 1761: 1753: 1749: 1741: 1737: 1729: 1725: 1717: 1710: 1702: 1695: 1687: 1683: 1675: 1671: 1667:, pp. 6–9. 1663: 1656: 1648: 1644: 1640:, pp. 6–7. 1636: 1623: 1615: 1611: 1603: 1588: 1578: 1576: 1567: 1566: 1562: 1554: 1550: 1546:, pp. 4–6. 1542: 1533: 1525: 1521: 1513: 1502: 1494: 1490: 1482: 1478: 1470: 1461: 1453: 1446: 1438: 1429: 1419: 1417: 1408: 1407: 1403: 1399:, pp. 7–8. 1395: 1391: 1383: 1372: 1364: 1360: 1356:, pp. 1–2. 1352: 1329: 1321: 1317: 1309: 1305: 1297: 1288: 1280: 1276: 1268: 1261: 1253: 1249: 1245:, pp. 3–4. 1241: 1218: 1214:, p. 1034. 1210: 1201: 1193: 1189: 1179: 1177: 1168: 1167: 1148: 1143: 1138: 1058: 1005: 998:Peter MacCallum 971: 949: 938: 867: 812: 799: 769:Cochrane review 717: 560: 552:Crohn's disease 479: 418: 356:, which causes 346:, which causes 315: 263: 243:Alfred Hospital 133: 129: 33: 28: 23: 22: 15: 12: 11: 5: 4269: 4259: 4258: 4253: 4248: 4229: 4228: 4226: 4225: 4217: 4215: 4209: 4208: 4205: 4204: 4202: 4201: 4200: 4199: 4187: 4186: 4185: 4173: 4172: 4171: 4158: 4156: 4150: 4149: 4147: 4146: 4139: 4138: 4137: 4116: 4114: 4108: 4107: 4104: 4103: 4100: 4099: 4097: 4096: 4089: 4082: 4074: 4072: 4061: 4060: 4058: 4057: 4054:M. haemophilum 4050: 4049: 4048: 4036: 4035: 4034: 4004: 4002: 3995: 3994: 3992: 3991: 3983: 3981: 3974: 3973: 3971: 3970: 3969: 3968: 3956: 3948: 3946: 3936: 3934:Nontuberculous 3930: 3929: 3927: 3926: 3921: 3916: 3911: 3906: 3901: 3891: 3889: 3881: 3880: 3878: 3877: 3872: 3867: 3862: 3857: 3852: 3847: 3842: 3841: 3840: 3830: 3825: 3824: 3823: 3818: 3813: 3808: 3803: 3801:Lupus vulgaris 3798: 3793: 3781: 3780: 3779: 3769: 3768: 3767: 3762: 3752: 3747: 3745:Ghon's complex 3733: 3731: 3715: 3706: 3700: 3699: 3696: 3695: 3693: 3692: 3684: 3682: 3676: 3675: 3673: 3672: 3665: 3664: 3663: 3651: 3650: 3649: 3635: 3634: 3633: 3628: 3615: 3613: 3604: 3602:Actinomycineae 3598: 3597: 3594:Actinomycetota 3586: 3585: 3578: 3571: 3563: 3554: 3553: 3550: 3549: 3537: 3536: 3534: 3530: 3529: 3526: 3525: 3514: 3503: 3488: 3467: 3462: 3461: 3459: 3458:Classification 3452: 3451: 3437: 3436:External links 3434: 3432: 3431: 3384: 3354:(5): 679–687. 3339: 3292: 3264:(4): 247–256. 3249: 3214: 3201: 3179: 3144: 3099: 3069:(4): 727–752. 3050: 3036: 3009: 2995: 2968: 2923: 2874: 2860: 2833: 2812: 2782: 2752:(5): 267–270. 2733: 2719: 2692: 2655: 2623:Human Genetics 2618: 2589: 2575: 2548: 2534: 2507: 2468: 2450:(2): 391–392. 2435: 2390: 2347: 2308: 2294: 2263: 2220: 2206: 2178: 2176: 2173: 2170: 2169: 2154: 2152:, p. 163. 2139: 2124: 2122:, p. 165. 2112: 2100: 2085: 2073: 2056: 2044: 2019: 2008: 1989: 1974: 1952: 1940: 1928: 1926:, p. 391. 1916: 1904: 1902:, p. 267. 1892: 1873: 1861: 1849: 1847:, p. 258. 1837: 1822: 1810: 1808:, p. 159. 1795: 1783: 1771: 1769:, p. 249. 1759: 1747: 1735: 1723: 1708: 1693: 1681: 1669: 1654: 1642: 1621: 1609: 1586: 1575:on 6 June 2020 1560: 1548: 1531: 1519: 1500: 1488: 1476: 1459: 1444: 1442:, p. 250. 1427: 1401: 1389: 1387:, p. 251. 1370: 1358: 1327: 1315: 1303: 1286: 1284:, p. 118. 1274: 1259: 1247: 1216: 1199: 1187: 1145: 1144: 1142: 1139: 1137: 1134: 1057: 1054: 994:Mengo Hospital 992:. In 1897, at 990:Albert R. Cook 982:Mengo Hospital 978:Albert R. Cook 970: 967: 955:Daintree River 937: 934: 866: 863: 811: 808: 798: 795: 741:clarithromycin 716: 713: 683:onchocerciasis 679:sebaceous cyst 583:histopathology 559: 556: 499:beta-defensins 478: 475: 417: 414: 314: 311: 287:bone infection 262: 259: 239:Mengo Hospital 227:clarithromycin 121: 120: 117: 113: 112: 110:clarithromycin 103: 99: 98: 91: 87: 86: 80: 74: 73: 68: 62: 61: 57: 56: 48: 47: 44: 40: 39: 31: 26: 18:Daintree ulcer 9: 6: 4: 3: 2: 4268: 4257: 4254: 4252: 4249: 4247: 4244: 4243: 4241: 4234: 4224: 4223: 4219: 4218: 4216: 4214: 4210: 4198: 4195: 4194: 4193: 4192: 4188: 4184: 4181: 4180: 4179: 4178: 4174: 4170: 4167: 4166: 4165: 4164: 4160: 4159: 4157: 4155: 4151: 4145: 4144: 4140: 4136: 4133: 4132: 4131: 4130: 4126: 4122: 4118: 4117: 4115: 4113: 4109: 4095: 4094: 4090: 4088: 4087: 4083: 4081: 4080: 4076: 4075: 4073: 4070: 4066: 4062: 4056: 4055: 4051: 4047: 4044: 4043: 4042: 4041: 4037: 4033: 4032:MAI infection 4030: 4029: 4028: 4024: 4023: 4018: 4017: 4012: 4010: 4006: 4005: 4003: 4000: 3996: 3990: 3989: 3985: 3984: 3982: 3979: 3975: 3967: 3964: 3963: 3962: 3961: 3957: 3955: 3954: 3950: 3949: 3947: 3944: 3940: 3937: 3935: 3931: 3925: 3922: 3920: 3917: 3915: 3912: 3910: 3907: 3905: 3902: 3900: 3896: 3893: 3892: 3890: 3888: 3887: 3882: 3876: 3873: 3871: 3868: 3866: 3863: 3861: 3858: 3856: 3853: 3851: 3848: 3846: 3843: 3839: 3836: 3835: 3834: 3831: 3829: 3826: 3822: 3819: 3817: 3814: 3812: 3809: 3807: 3804: 3802: 3799: 3797: 3794: 3792: 3791:Scrofuloderma 3789: 3788: 3787: 3786: 3782: 3778: 3775: 3774: 3773: 3770: 3766: 3763: 3761: 3758: 3757: 3756: 3753: 3751: 3748: 3746: 3742: 3738: 3735: 3734: 3732: 3730: 3729: 3724: 3719: 3716: 3714: 3710: 3707: 3705: 3701: 3691: 3690: 3686: 3685: 3683: 3681: 3677: 3671: 3670: 3666: 3662: 3659: 3658: 3657: 3656: 3652: 3648: 3645: 3644: 3642: 3641: 3636: 3632: 3629: 3627: 3626:Actinomycosis 3624: 3623: 3622: 3621: 3617: 3616: 3614: 3612: 3608: 3605: 3603: 3599: 3595: 3591: 3584: 3579: 3577: 3572: 3570: 3565: 3564: 3561: 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2129: 2121: 2116: 2109: 2104: 2097: 2092: 2090: 2083:, p. 50. 2082: 2077: 2070: 2065: 2063: 2061: 2053: 2048: 2029: 2023: 2015: 2011: 2005: 2001: 2000: 1993: 1986: 1981: 1979: 1962: 1956: 1949: 1944: 1937: 1932: 1925: 1920: 1914:, p. 64. 1913: 1908: 1901: 1896: 1889: 1884: 1882: 1880: 1878: 1870: 1865: 1858: 1853: 1846: 1841: 1835:, p. 44. 1834: 1829: 1827: 1819: 1814: 1807: 1802: 1800: 1792: 1787: 1780: 1775: 1768: 1763: 1756: 1751: 1744: 1739: 1732: 1727: 1720: 1715: 1713: 1705: 1700: 1698: 1690: 1685: 1678: 1673: 1666: 1661: 1659: 1651: 1646: 1639: 1634: 1632: 1630: 1628: 1626: 1618: 1613: 1606: 1601: 1599: 1597: 1595: 1593: 1591: 1574: 1570: 1564: 1557: 1552: 1545: 1540: 1538: 1536: 1528: 1523: 1516: 1511: 1509: 1507: 1505: 1497: 1492: 1485: 1480: 1473: 1468: 1466: 1464: 1456: 1451: 1449: 1441: 1436: 1434: 1432: 1415: 1411: 1405: 1398: 1393: 1386: 1381: 1379: 1377: 1375: 1367: 1362: 1355: 1350: 1348: 1346: 1344: 1342: 1340: 1338: 1336: 1334: 1332: 1324: 1319: 1313:, p. 52. 1312: 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Strains of 1119: 1115: 1111: 1107: 1105: 1101: 1098: 1094: 1090: 1089: 1084: 1079: 1075: 1071: 1067: 1063: 1053: 1051: 1045: 1043: 1042: 1037: 1036: 1035:PLOS Medicine 1031: 1026: 1021: 1019: 1018:Buruli County 1015: 1011: 1006:H. A. Sissons 1003: 1002:Jean Tolhurst 999: 995: 991: 983: 979: 975: 966: 964: 960: 956: 946: 944: 943:social stigma 933: 931: 930:anole lizards 927: 923: 919: 915: 911: 907: 903: 899: 895: 891: 887: 883: 876: 871: 865:Other animals 862: 858: 856: 852: 848: 844: 841:and north of 840: 835: 830: 825: 816: 807: 805: 794: 791: 787: 783: 777: 775: 770: 766: 762: 758: 754: 750: 746: 745:ciprofloxacin 742: 738: 734: 726: 721: 712: 710: 706: 705: 700: 696: 692: 691:leishmaniasis 688: 684: 680: 675: 673: 669: 668:tissue sample 664: 660: 656: 652: 648: 644: 640: 636: 632: 628: 624: 620: 619:real-time PCR 616: 615:gold standard 612: 608: 600: 596: 592: 588: 584: 580: 576: 572: 568: 564: 555: 553: 549: 545: 541: 540: 535: 534: 529: 528: 523: 522: 517: 516: 511: 510: 504: 500: 496: 492: 488: 484: 474: 471: 467: 463: 459: 455: 451: 447: 443: 439: 435: 431: 422: 413: 411: 407: 403: 402:immune system 399: 395: 391: 387: 383: 379: 375: 371: 367: 363: 359: 355: 354: 349: 345: 344: 339: 338: 333: 332:mycobacterium 329: 325: 324: 320: 310: 307: 302: 298: 296: 292: 288: 284: 279: 275: 267: 258: 256: 252: 248: 244: 240: 236: 230: 228: 224: 220: 215: 213: 209: 205: 201: 197: 193: 192: 187: 182: 180: 176: 172: 168: 163: 157: 127: 118: 114: 111: 107: 104: 100: 97: 96: 92: 88: 85: 81: 79: 75: 72: 69: 67: 63: 58: 54: 49: 45: 41: 36: 30: 19: 4233: 4220: 4189: 4175: 4161: 4141: 4119: 4112:Nocardiaceae 4093:M. abscessus 4091: 4084: 4079:M. fortuitum 4077: 4052: 4046:Buruli ulcer 4045: 4038: 4020: 4014: 4008: 3986: 3958: 3951: 3884: 3783: 3754: 3750:Pott disease 3737:Tuberculosis 3721: 3687: 3667: 3653: 3638: 3618: 3547:Buruli ulcer 3540: 3516: 3505: 3490: 3470: 3448:Buruli ulcer 3400: 3396: 3390: 3351: 3347: 3308: 3304: 3298: 3261: 3257: 3226: 3222: 3206:. 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Searls 947: 939: 909: 905: 889: 881: 880: 874: 859: 826: 822: 810:Epidemiology 800: 778: 765:levofloxacin 761:azithromycin 749:moxifloxacin 730: 702: 676: 672:histological 662: 646: 634: 630: 626: 622: 610: 604: 591:mycobacteria 571:punch biopsy 547: 537: 531: 525: 519: 513: 507: 501:, which are 480: 469: 445: 441: 437: 429: 427: 416:Transmission 365: 361: 351: 348:tuberculosis 341: 335: 327: 321: 316: 303: 299: 280: 276: 272: 231: 216: 208:tissue death 199: 195: 189: 183: 126:Buruli ulcer 125: 124: 93: 38:Buruli ulcer 29: 4135:Nocardiosis 4086:M. chelonae 4040:M. ulcerans 3988:M. gordonae 3953:M. kansasii 3208:20 December 2175:Works cited 1869:Meyers 2007 1126:M. ulcerans 1122:M. ulcerans 1110:M. ulcerans 1104:M. ulcerans 1097:M. ulcerans 1093:BCG vaccine 1083:M. ulcerans 1078:M. ulcerans 1066:M. ulcerans 1062:M. ulcerans 910:M. ulcerans 906:M. ulcerans 890:M. ulcerans 882:M. ulcerans 875:M. ulcerans 839:Rockhampton 829:West Africa 804:BCG vaccine 733:antibiotics 663:M. ulcerans 651:insensitive 647:M. ulcerans 635:M. ulcerans 631:M. ulcerans 627:M. ulcerans 611:M. ulcerans 470:M. ulcerans 446:M. ulcerans 442:M. ulcerans 438:M. ulcerans 430:M. ulcerans 410:neutrophils 370:mycolactone 366:M. ulcerans 362:M. ulcerans 328:M. ulcerans 237:in 1897 at 204:mycolactone 200:M. ulcerans 43:Other names 4240:Categories 4183:Erythrasma 4169:Diphtheria 3960:M. marinum 3833:Tuberculid 3765:Rich focus 3760:Meningitis 3741:Ghon focus 3542:Patient UK 3518:DiseasesDB 2827:3 November 2477:infection" 1472:Manry 2020 1420:24 January 1414:abc.net.au 1282:Bravo 2019 1180:31 October 1136:References 847:Bairnsdale 797:Prevention 753:ethambutol 737:rifampicin 709:cellulitis 681:, lipoma, 466:Naucoridae 390:cell death 223:rifampicin 106:Rifampicin 3886:M. leprae 3785:cutaneous 3301:disease)" 2666:(1): 63. 2651:215405517 2259:207900168 1141:Citations 851:Melbourne 767:. A 2018 715:Treatment 595:acid-fast 558:Diagnosis 487:kilobases 398:signaling 394:apoptosis 319:bacterium 247:Melbourne 116:Frequency 102:Treatment 66:Specialty 4009:M. avium 3728:M. bovis 3487:A31.120) 3427:29237707 3380:29635431 3335:30136733 3288:30460172 3245:26332541 3175:16283056 3140:29708969 3095:25278573 3046:32091704 3005:32091702 2964:31200890 2919:32523571 2893:: 1018. 2870:32091710 2822:32091709 2778:24641151 2729:32091698 2688:20007397 2680:17605723 2643:32266523 2614:18876541 2585:32091699 2544:32091705 2503:20185351 2431:31999732 2386:29343539 2343:19079352 2304:32091708 2251:31685961 2216:32091701 1174:Archived 1118:colonies 1100:antigens 1056:Research 886:Victoria 790:grafting 786:removing 757:amikacin 725:Ghanaian 617:test is 483:Beninese 458:crayfish 456:, fish, 186:bacteria 160:) is an 78:Symptoms 4011:complex 3895:Leprosy 3850:Miliary 3512:D054312 3418:5740976 3326:6513118 3279:6223704 3166:2626418 3131:5945055 3086:4187642 2955:6614043 2910:7261859 2464:2451445 2422:6991948 2377:5869816 2037:14 June 1579:19 June 1074:C57BL/6 969:History 959:Mossman 928:), and 782:surgery 599:bacilli 575:stained 548:ATG16L1 527:ATG16L1 509:SLC11A1 434:endemic 386:cytosol 358:leprosy 188:called 179:tendons 175:muscles 3425: 3415: 3378: 3333: 3323: 3286: 3276: 3243: 3199: 3173: 3163: 3138: 3128: 3093: 3083: 3044: 3034: 3003: 2993: 2962: 2952: 2917: 2907: 2868: 2858: 2820: 2810: 2776: 2727: 2717: 2686: 2678: 2649: 2641: 2612: 2583: 2573: 2542: 2532: 2501: 2462: 2429: 2419: 2384: 2374: 2341: 2302: 2292: 2257: 2249: 2214: 2204: 2006: 1967:5 June 1130:Adzopé 1114:plated 1070:BALB/c 900:, and 894:koalas 855:Honshu 843:Cairns 763:, and 727:woman 536:, and 464:, and 350:, and 167:nodule 90:Causes 3755:brain 3501:031.1 3481:A31.1 3193:(PDF) 2790:(PDF) 2684:S2CID 2647:S2CID 2255:S2CID 2031:(PDF) 577:with 569:of a 378:Sec61 330:is a 313:Cause 283:dying 171:ulcer 84:ulcer 3523:8568 3507:MeSH 3496:9-CM 3485:ILDS 3423:PMID 3376:PMID 3331:PMID 3309:2018 3284:PMID 3241:PMID 3210:2020 3197:ISBN 3171:PMID 3136:PMID 3091:PMID 3042:PMID 3032:ISBN 3001:PMID 2991:ISBN 2960:PMID 2915:PMID 2866:PMID 2856:ISBN 2829:2020 2818:PMID 2808:ISBN 2774:PMID 2725:PMID 2715:ISBN 2676:PMID 2639:PMID 2610:PMID 2581:PMID 2571:ISBN 2540:PMID 2530:ISBN 2499:PMID 2460:PMID 2427:PMID 2382:PMID 2339:PMID 2300:PMID 2290:ISBN 2247:PMID 2212:PMID 2202:ISBN 2039:2020 2004:ISBN 1969:2020 1581:2020 1422:2024 1182:2019 1072:and 916:and 849:and 695:yaws 623:2404 539:IFNG 533:iNOS 521:NOD2 515:PRKN 374:host 304:The 225:and 217:The 210:and 177:and 108:and 4027:MAP 3492:ICD 3472:ICD 3413:PMC 3405:doi 3366:hdl 3356:doi 3352:218 3321:PMC 3313:doi 3274:PMC 3266:doi 3231:doi 3161:PMC 3126:PMC 3116:doi 3081:PMC 3071:doi 3022:doi 2981:doi 2950:PMC 2940:doi 2905:PMC 2895:doi 2846:doi 2798:doi 2764:hdl 2754:doi 2750:200 2705:doi 2668:doi 2664:187 2631:doi 2627:139 2602:doi 2561:doi 2520:doi 2489:doi 2452:doi 2417:PMC 2407:doi 2372:PMC 2364:doi 2329:doi 2280:doi 2237:doi 2192:doi 1008:at 489:of 450:DNA 392:by 295:red 245:in 4242:: 4069:RG 4065:R4 3999:R3 3978:R2 3943:R1 3897:: 3739:: 3643:" 3592:: 3545:: 3521:: 3510:: 3499:: 3479:: 3476:10 3421:. 3411:. 3401:31 3399:. 3395:. 3374:. 3364:. 3350:. 3346:. 3329:. 3319:. 3307:. 3303:. 3282:. 3272:. 3260:. 3256:. 3239:. 3227:42 3225:. 3221:. 3169:. 3157:83 3155:. 3151:. 3134:. 3124:. 3112:12 3110:. 3106:. 3089:. 3079:. 3067:27 3065:. 3061:. 3040:. 3030:. 2999:. 2989:. 2958:. 2948:. 2934:. 2930:. 2913:. 2903:. 2891:11 2889:. 2885:. 2864:. 2854:. 2816:. 2806:. 2772:. 2762:. 2748:. 2744:. 2723:. 2713:. 2682:. 2674:. 2662:. 2645:. 2637:. 2625:. 2608:. 2598:60 2596:. 2579:. 2569:. 2538:. 2528:. 2497:. 2485:14 2483:. 2479:. 2458:. 2448:38 2446:. 2425:. 2415:. 2403:14 2401:. 2397:. 2380:. 2370:. 2360:56 2358:. 2354:. 2337:. 2323:. 2319:. 2298:. 2288:. 2253:. 2245:. 2233:33 2231:. 2227:. 2210:. 2200:. 2157:^ 2142:^ 2127:^ 2088:^ 2059:^ 1977:^ 1876:^ 1825:^ 1798:^ 1711:^ 1696:^ 1657:^ 1624:^ 1589:^ 1534:^ 1503:^ 1462:^ 1447:^ 1430:^ 1412:. 1373:^ 1330:^ 1289:^ 1262:^ 1219:^ 1202:^ 1149:^ 1044:. 1000:, 932:. 896:, 759:, 755:, 751:, 747:, 701:, 697:, 693:, 661:. 597:) 554:. 530:, 524:, 518:, 512:, 468:. 326:. 257:. 147:uː 4127:/ 4123:/ 4071:: 4067:/ 4025:/ 4019:/ 4013:/ 4001:: 3980:: 3945:: 3743:/ 3725:/ 3637:" 3582:e 3575:t 3568:v 3494:- 3483:( 3474:- 3464:D 3429:. 3407:: 3393:" 3382:. 3368:: 3358:: 3337:. 3315:: 3290:. 3268:: 3262:5 3247:. 3233:: 3212:. 3177:. 3142:. 3118:: 3097:. 3073:: 3059:" 3048:. 3024:: 3007:. 2983:: 2966:. 2942:: 2936:7 2921:. 2897:: 2883:" 2872:. 2848:: 2831:. 2800:: 2780:. 2766:: 2756:: 2731:. 2707:: 2690:. 2670:: 2653:. 2633:: 2616:. 2604:: 2587:. 2563:: 2546:. 2522:: 2505:. 2491:: 2466:. 2454:: 2433:. 2409:: 2388:. 2366:: 2345:. 2331:: 2325:7 2317:" 2306:. 2282:: 2268:" 2261:. 2239:: 2218:. 2194:: 2041:. 1971:. 1583:. 1424:. 1184:. 877:. 156:/ 153:i 150:l 144:r 141:ˈ 138:ə 135:b 132:/ 128:( 20:)

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