Volume 76, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Buruli ulcer, caused by , is a destructive infection that most commonly affects the skin. Animal models for Buruli ulcer include guinea pigs, rats, mice, and armadillos, but each is limited in replicating the spectrum of human disease. Here, a cynomolgus monkey was infected with two concentrations of (1.0 and 2.2 × 10) by intradermal inoculation, 3 months apart. All injection sites developed papules that progressed to ulcers with undermined borders within 2–4 weeks. The rate of progression and size of the ulcers were proportional to the numbers of organisms inoculated. Biopsies from ulcer edges showed ulceration, robust inflammatory cell infiltrates, granulomatous-like responses, mild edema, and extracellular acid-fast bacilli. The ulcers healed spontaneously between Weeks 8 and 12, with no signs of systemic infection. This report, the first to describe a non-human primate experimentally infected with , suggests that cynomolgus monkeys are modestly susceptible and develop some of the clinical and histologic features of Buruli ulcer.


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  1. Wansbrough-Jones M, Phillips R, 2006. Buruli ulcer: Emerging from obscurity. Lancet 367 : 1849–1858. [Google Scholar]
  2. Sizaire V, Nackers F, Comte E, Portaels F, 2006. Mycobacterium ulcerans infection: Control, diagnosis, and treatment. Lancet Infect Dis 6 : 288–296. [Google Scholar]
  3. van der Werf TS, Stinear T, Stienstra Y, van der Graaf WT, Small PL, 2003. Mycolactones and Mycobacterium ulcerans disease. Lancet 362 : 1062–1064. [Google Scholar]
  4. World Health Organization, 2004. Provisional Guidance on the Role of Specific Antibiotics in the Management of Mycobacterium ulcerans Disease (Buruli Ulcer). Geneva: World Health Organization.
  5. Singh NB, Srivastava A, Verma VK, Kumar A, Gupta SK, 1984. Mastomys natalensis: A new animal model for Mycobacterium ulcerans research. Indian J Exp Biol 22 : 393–394. [Google Scholar]
  6. Pattyn SR, Royackers J, 1965. Treatment of experimental infection by Mycobacterium ulcerans and Mycobacterium balnei in mice. Ann Soc Belg Med Trop 45 : 31–38. [Google Scholar]
  7. Read JK, Heggie CM, Meyers WM, Connor DH, 1974. Cytotoxic activity of Mycobacterium ulcerans. Infect Immun 9 : 1114–1122. [Google Scholar]
  8. Krieg RE, Hockmeyer WT, Connor DH, 1974. Toxin of Mycobacterium ulcerans. Production and effects in guinea pig skin. Arch Dermatol 110 : 783–788. [Google Scholar]
  9. Walsh DS, Meyers WM, Krieg RE, Walsh GP, 1999. Transmission of Mycobacterium ulcerans to the nine-banded armadillo. Am J Trop Med Hyg 61 : 694–697. [Google Scholar]
  10. Walsh GP, Tan EV, dela Cruz EC, Abalos RM, Villahermosa LG, Young LJ, Cellona RV, Nazareno JB, Horwitz MA, 1996. The Philippine cynomolgus monkey (Macaca fasicularis) provides a new nonhuman primate model of tuberculosis that resembles human disease. Nat Med 2 : 430–436. [Google Scholar]
  11. Mve-Obiang A, Lee RE, Portaels F, Small PL, 2003. Heterogeneity of mycolactones produced by clinical isolates of Mycobacterium ulcerans: implications for virulence. Infect Immun 71 : 774–783. [Google Scholar]
  12. Stinear T, Ross BC, Davies JK, Marino L, Robins-Browne RM, Oppedisano F, Sievers A, Johnson PDR, 1999. Identification and characterization of IS2404 and IS2606: two distinct repeated sequences for detection of Mycobacterium ulcerans by PCR. J Clin Microbiol 37 : 1018–1023. [Google Scholar]
  13. Guarner J, Bartlett J, Whitney EA, Raghunathan PL, Stienstra Y, Asamoa K, Etuaful S, Klutse E, Quarshie E, van der Werf TS, van der Graaf WT, King CH, Ashford DA, 2003. Histopathologic features of Mycobacterium ulcerans infection. Emerg Infect Dis 9 : 651–656. [Google Scholar]
  14. George KM, Pascopella L, Welty DM, Small PL, 2000. A Mycobacterium ulcerans toxin, mycolactone, causes apoptosis in guinea pig ulcers and tissue culture cells. Infect Immun 68 : 877–883. [Google Scholar]
  15. Walsh DS, Meyers WM, Portaels F, Lane JE, Mongkolsirichaikul D, Hussem K, Gosi P, Myint KS, 2005. High rates of apoptosis in human Mycobacterium ulcerans culture-positive Buruli ulcer skin lesions. Am J Trop Med Hyg 73 : 410–415. [Google Scholar]

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  • Received : 28 Jul 2006
  • Accepted : 03 Sep 2006

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