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A Cutaneous Ulcer Resulting from Mycobacterium ulcerans—Leishmania braziliensis Coinfection in South America
Buruli ulcer is a tropical skin disease caused by Mycobacterium ulcerans. Its mode of transmission is not yet clearly understood. We report here a cutaneous ulcer in a European traveler in South America resulting from a coinfection detected specifically for Mycobacterium ulcerans and Leishmania braziliensis DNA with real-time polymerase chain reaction. This observation of a unique cutaneous ulcer raises the issue about possible modes of transmission of those two pathogens by the same vector.
Author Notes
Authors' addresses: Benjamin Mougin and Pierre Abgueguen, Department of Infectious Diseases and Internal Medicine, Centre Hospitalier Universitaire d'Angers, Angers Cedex 9, France, E-mails: ptidoc_mougin@yahoo.fr and piabgueguen@chu-angers.fr. Martine Avenel-Audran and Ludovic Martin, Department of Dermatology, Centre Hospitalier Universitaire d'Angers, Angers Cedex 9, France, E-mails: maavenel-audran@chu-angers.fr and lumartin@chu-angers.fr. Lilia Hasseine, Christelle Pomares, Pascal Delaunay, and Pierre Marty, Parasitologie-Mycologie, Centre Hospitalier Universitaire de Nice et Université de Nice-Sophia Antipolis, Inserm U 895, Equipe 6, Hôpital de l'Archet, Nice cedex 3 Cedex 1, France, E-mails: hasseine.l@chu-nice.fr, pomares.c@chu-nice.fr, delaunay.p@chu-nice.fr, and marty.p@chu-nice.fr. Jane Cottin, Department of Bacteriology and Virology, Centre Hospitalier Universitaire d'Angers, Angers Cedex 9, France, E-mail: jacottin@chu-angers.fr. Christophe Ravel, French Reference Centre on Leishmaniasis, Department of Parasitology—Mycology, Montpellier, France, E-mail: christophe.ravel@univ-montp1.fr. Dominique Chabasse, Department of Parasitology, Centre Hospitalier Universitaire d'Angers, Angers Cedex 9, France, E-mail: dochabasse@chu-angers.fr.