Buruli ulcer of the foot in an urban dweller: a case report and review of the literature

Abstract

Buruli ulcer (BU) is a chronic cutaneous ulcer caused by Mycobacterium ulcerans. It is the third most common mycobacteria infection of immunocompetent host, after tuberculosis and leprosy. The index case is a 24year-old male with a left foot ulcer of 3weeks duration. It initially started as a single painless papule, then subsequent suppuration and necrotic ulceration followed. Complete wound healing was achieved following long course of treatment with rifampicin and clarithromycin; and wound care with debridement, dressing and split-thickness skin grafting. A high index of suspicion for the diagnosis of BU is necessary for a foot ulcer in the tropics, especially when there is no response to initial conventional wound care. A work-up for BU should be instituted and it responds to rifampicin and wound care.