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Diagnostic Work-up of Buruli Ulcer

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Leprosy and Buruli Ulcer

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Abstract

Buruli ulcer (BU), caused by Mycobacterium ulcerans, is a neglected tropical disease with polymorphic skin manifestations. The great variability in clinical presentation and the broad range of similar conditions make management difficult, especially in developing countries, where clinicians often have to work with limited laboratory support. Trained nurses at peripheral healthcare centers rely on key epidemiological and clinical criteria. In case of doubt, medical doctors from reference hospitals at the district level confirm the diagnosis.

Diagnosis requires careful skin and general clinical examination of the patient. The diagnostic approach is conducted in three steps: history, clinical examination of the skin, and general clinical examination.

BU presents in two standard clinical forms: nonulcerative and ulcerative forms. Less commonly, BU can present as osteomyelitis, scars, mixed forms, and multifocal lesions.

Each clinical form has a number of differential diagnoses, which can often be confirmed or ruled out by combining with other symptoms, signs, or laboratory examinations.

There are five laboratory methods available to support or confirm a diagnosis of BU. Ideally, two positive results are required to confirm the BU diagnosis, and, in most places, PCR remains the most common and practical diagnostic test.

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Author information

Authors and Affiliations

  1. Institut régional de santé publique, University of Abomey-Calavi, Ouidah, Benin

    Ghislain E. Sopoh

  2. Buruli Ulcer Treatment Center of Lalo, Ministry of Health, Lalo, Benin

    Yves T. Barogui

  3. Institute of Tropical Medicine, Antwerpen, Belgium

    Bouke C. de Jong

  4. Department of Infectious Diseases, Austin Health and University of Melbourne, Melbourne, VIC, Australia

    Paul D. R. Johnson

Authors
  1. Ghislain E. Sopoh
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  2. Yves T. Barogui
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  3. Bouke C. de Jong
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  4. Paul D. R. Johnson
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Corresponding author

Correspondence to Ghislain E. Sopoh .

Editor information

Editors and Affiliations

  1. Departamento de Dermatología, Universidad Técnica Particular de Loja, Loja, Ecuador

    Enrico Nunzi

  2. Dermatoloy Unit & Scientific Coordinator, Galliera Hospital, Genova, Italy

    Cesare Massone

  3. Mycobacteriology Department, Institute of Tropical Medicine Antwerp, Antwerpen, Belgium

    Françoise Portaels

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Sopoh, G.E., Barogui, Y.T., de Jong, B.C., Johnson, P.D.R. (2022). Diagnostic Work-up of Buruli Ulcer. In: Nunzi, E., Massone, C., Portaels, F. (eds) Leprosy and Buruli Ulcer. Springer, Cham. https://doi.org/10.1007/978-3-030-89704-8_44

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  • DOI: https://doi.org/10.1007/978-3-030-89704-8_44

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