Third most common mycobacterial infection worldwide, after TB and leprosy
Present in Africa, South America, and Western Pacific
Clinical Manifestations
Present with one or more painless skin lesions
Typically painless
May involve bone (osteitis and osteomyelitis)
Often severe residual scarring
Not usually with fever or lymphadenopathy
Management
Standard treatment is: rifampicin 10 mg/kg po plus streptomycin 15 mg/kg IM once daily for 8 weeks (RS8)
For early ulcers, may be able to do an oral regimen of rifampicin 10 mg/kg po plus clarithromycin ER 15 mg/kg po daily for 8 weeks (RC8)1
References
^Richard O Phillips, Jérôme Robert, Kabiru Mohamed Abass, William Thompson, Fred Stephen Sarfo, Tuah Wilson, Godfred Sarpong, Thierry Gateau, Annick Chauty, Raymond Omollo, Michael Ochieng Otieno, Thaddaeus W Egondi, Edwin O Ampadu, Didier Agossadou, Estelle Marion, Line Ganlonon, Mark Wansbrough-Jones, Jacques Grosset, John M Macdonald, Terry Treadwell, Paul Saunderson, Albert Paintsil, Linda Lehman, Michael Frimpong, Nanaa Francisca Sarpong, Raoul Saizonou, Alexandre Tiendrebeogo, Sally-Ann Ohene, Ymkje Stienstra, Kingsley B Asiedu, Tjip S van der Werf, Samuel Osei Mireku, Justice Abotsi, Joseph Ken Adu Poku, Richard Asamoah-Frimpong, Bright Osei-Wusu, Edward Sarpong, Beatrice Konadu, Ernest Opoku, Mark Forson, Mathias Ndogyele, Elizabeth Ofori, Felicity Aboagye, Thomas Berko, George Amofa, Anastasia Nsiah, Joyce Mensah-Bonsu, Joseph Ofori Nyarko, Yaw Ampem Amoako, Elliot Koranteng Tannor, Justice Boakye-Appiah, Aloysius Dzibordzi Loglo, Mabel Sarpong-Duah, Bernadette Agbavor, Marie Françoise Ardent, Arnaud Yamadjako, Naomi Adanmado Gersande, Ambroise Adeye, Martial Kindjinou, Akpolan, Maxime Kiki, Espoir Sodjinou, Clémence Guegnard, Sandor-Adrian Klis, Kristien Velding, Till Omansen, David Ofori-Adjei, Sarah Eyangoh, Alan Knell, William Faber. Rifampicin and clarithromycin (extended release) versus rifampicin and streptomycin for limited Buruli ulcer lesions: a randomised, open-label, non-inferiority phase 3 trial. The Lancet. 2020. doi:10.1016/s0140-6736(20)30047-7.
