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A severe case of Mycobacterium ulcerans (Buruli ulcer) osteomyelitis requiring a below-knee amputation

Michael J Loftus, Nicola Kettleton-Butler, Denton Wade, R Michael Whitby and Paul DR Johnson
Med J Aust 2018; 208 (7): . || doi: 10.5694/mja17.01158
Published online: 16 April 2018

Clinical record


  • 1 Austin Health, Melbourne, VIC
  • 2 Victoria Department of Health and Human Services, Melbourne, VIC
  • 3 Saltwater Medical, Caloundra, QLD
  • 4 Tyack Health, Brisbane, QLD
  • 5 University of Queensland, Brisbane, QLD


Correspondence: paul.johnson@austin.org.au

Competing interests:

No relevant disclosures.

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  • 2. O’Brien DP, Walton A, Hughes AJ, et al. Risk factors for recurrent Mycobacterium ulcerans disease after exclusive surgical treatment in an Australian cohort. Med J Aust 2013; 198: 436-439. <MJA full text>
  • 3. Kanga JM, Kacou DE, Sangaré A, et al. Recurrence after surgical treatment of Buruli ulcer in Cote d’Ivoire. Bull Soc Pathol Exot 2003; 96: 406-409.
  • 4. Pommelet V, Vincent QB, Ardant MF, et al. Findings in patients from Benin with osteomyelitis and polymerase chain reaction-confirmed Mycobacterium ulcerans infection. Clin Infect Dis 2014; 59: 1256-1264.
  • 5. O’Brien DP, Jenkin G, Buntine J, et al. Treatment and prevention of Mycobacterium ulcerans infection (Buruli ulcer) in Australia: guideline update. Med J Aust 2014; 200: 267-270. <MJA full text>
  • 6. Jenkin GA, Smith M, Fairley M, Johnson PD. Acute, oedematous Mycobacterium ulcerans infection in a farmer from far north Queensland. Med J Aust 2002; 176: 180-181. <MJA full text>
  • 7. O’Brien DP, Robson M, Friedman ND, et al. Incidence, clinical spectrum, diagnostic features, treatment and predictors of paradoxical reactions during antibiotic treatment of Mycobacterium ulcerans infections. BMC Infect Dis 2013; 13: 416.
  • 8. Nienhuis WA, Stienstra Y, Abass KM, et al. Paradoxical responses after start of antimicrobial treatment in Mycobacterium ulcerans infection. Clin Infect Dis 2012; 54: 519-526.

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