Human Mycobacterium Ulcerans Infections Developing at Sites of Trauma to Skin

Wayne M. Meyers Leprosy Atelier, Department of Pathology, University of Hawaii School of Medicine, Department of Surgery, Institut Médical Evangélique, Kimpese via Kinshasa, Republic of Zaire, and Geographic Pathology Division, Armed Forces Institute of Pathology, Honolulu, Hawaii 96816

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Walter M. Shelly Leprosy Atelier, Department of Pathology, University of Hawaii School of Medicine, Department of Surgery, Institut Médical Evangélique, Kimpese via Kinshasa, Republic of Zaire, and Geographic Pathology Division, Armed Forces Institute of Pathology, Honolulu, Hawaii 96816

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Daniel H. Connor Leprosy Atelier, Department of Pathology, University of Hawaii School of Medicine, Department of Surgery, Institut Médical Evangélique, Kimpese via Kinshasa, Republic of Zaire, and Geographic Pathology Division, Armed Forces Institute of Pathology, Honolulu, Hawaii 96816

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Esther K. Meyers Leprosy Atelier, Department of Pathology, University of Hawaii School of Medicine, Department of Surgery, Institut Médical Evangélique, Kimpese via Kinshasa, Republic of Zaire, and Geographic Pathology Division, Armed Forces Institute of Pathology, Honolulu, Hawaii 96816

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In Zaire, we studied 180 patients with Mycobacterium ulcerans infections and found 14 with a history of antecedent trauma at the site of the lesion (e.g., gunshot and land mine injuries, penetrating wood splinters, and scorpion stings). Two patients developed lesions following hypodermic injections. We believe that trauma is an important mode of transmitting M. ulcerans infections, or of introducing the etiologic agent into the dermis or subcutaneous tissue from superficially contaminated skin.

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