Previous Health Alerts - Mycobacterium Ulcerans Skin Ulcers

Issued: 9 August 2001

Health Warning: Mycobacterium Ulcerans Skin Ulcers

The Department has had an increase in reporting of M. ulcerans skin ulcers ("Bairnsdale ulcers") this year, particularly from the Bellarine and Mornington Peninsulas. Other known endemic areas include Phillip Island and Gippsland.

As you may recall, this is a rare infection which causes chronic, progressive skin ulcers, usually on exposed parts of the body such as the arms or legs. The infection begins as a painless or itchy pimple which breaks down to form an ulcer which can become extensive if untreated. Mature lesions have characteristic undermined edges. When identified and excised early there is a high cure rate with minimal scarring. If left untreated the ulcer can continue to enlarge, sometimes requiring extensive surgical excision and skin grafts.

The bacterium is thought to live in water and wetlands although it has been difficult to isolate in the environment. It should be stressed that there is no evidence to suggest the infection can be passed on from person to person.

We are asking that general practitioners consider the diagnosis of M. ulcerans in all atypical ulcers, particularly when painless and where the patient has a history of exposure to an endemic area, i.e. the Bellarine or Mornington Peninsulas, Phillip Island or Gippsland.

For diagnosis take a dry skin swab or biopsy for acid-fast bacilli. Positive swabs are forwarded for confirmation using the new PCR test now available.

If you have a suspected or confirmed case of M. ulcerans, or you require further information please contact the Communicable Diseases Section (DHS) on:
1300 651160.

Yours sincerely

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Dr John Catford
Chief Health Officer

For further information on diagnosis and treatment: http://members.ozemail.com.au/~groverjohnson/Mulcerans.htm