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After tuberculosis and leprosy,Mycobacterium ulceransinfection (Buruli ulcer) is the third most important and probably the third most common mycobacterial disease of immunocompetent human.1Buruli ulcers often cause massive destruction of skin and subcutaneous tissue that, without appropriate therapy, often leave grossly deforming sequelae.2Wide excision of the ulcers with subsequent skin grafting and physical therapy prevents many of these disastrous results. Buruli ulcers prevail in focal riverine and swampy localities of numerous tropical regions, including most countries of West Africa, and afflict many impoverished inhabitants, primarily children, of remote areas where the amenities of modern medical science are unavailable or too expensive. In 1988, Muelder3was the first to describe a patient with Buruli ulcer in Benin. Subsequent observations suggest a relatively high prevalence in Benin.4In 1993, for example, the dispensary of the Catholic Mission of Zangnanado, one of the few centers in |
