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Die Infektion des Menschen mit Mycobacterium ulcerans (Buruli-Ulkus)

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Zusammenfassung

Das Buruli-Ulkus wird durch Mycobacterium ulcerans, ein salzsäure-alkoholfestes Stäbchenbakterium, verursacht. Es findet sich vorwiegend an den Extremitäten als chronisches Ulkus mit weit unterminierten Rändern und ausgedehnten Nekrosen des subkutanen Fettgewebes. Die Heilungstendenz ist schlecht. Die Infektionskrankheit wird hauptsächlich bei Kleinkindern und Jugendlichen beobachtet. Das Auftreten der Erkrankung ist an eine mittlere Jahrestemperatur von 23°C gebunden; es handelt sich demnach um eine tropische Infektionskrankheit. Das Ulkus wurde, mit Ausnahmen, nur bei Farbigen beschrieben. Die Inkubationszeit der Erkrankung beträgt 4–13 Wochen; ihre Epidemiologie, der Infektionsmodus und die Frage einer Resistenz des Menschen und einer möglichen Immunität sind noch ungeklärt. Im Tierversuch können mit M. ulcerans vorzugsweise Ratten und Mäuse infiziert werden. Als Chemotherapeutikum der Wahl gilt heute das Riminophenazon-Derivat Lampren®.

Summary

Buruli ulcer is caused by Mycobacterium ulcerans, an acid-fast (HCl), alcohol-fast, rodshaped bacillus. It occurs mainly in the extremities as a chronic ulcer with considerably undermined margins and extensive necroses of the subcutaneous fatty tissues. The tendency to heal is poor. The infection is observed principally in small children and juveniles. The appearance of the disease is bound up with a mean annual temperature of 23°C. It is therefore a tropical infectious disease. With exceptions, the ulcer has only been described in coloured persons. The incubation period for the disease is 4 to 13 weeks, its epidemiology, mode of infection and the question of a resistance in humans and a possible immunity are still not known. In animal experiments with M. ulcerans, rats and mice can be infected preferentially. The chemotherapeutic agent of choice today is the riminophenazine derivative, Lamprene.

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Authors and Affiliations

  1. Aus der Chirurgischen Klinik, dem Pathologischen Institut, dem Hygiene-Institut und dem Tropenmedizinischen Institut der Universität Tübingen, Germany

    G. Kieninger, G. E. Schubert, U. Ullmann & W. Höfler

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  1. G. Kieninger
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  2. G. E. Schubert
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  3. U. Ullmann
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  4. W. Höfler
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Herrn Prof. Dr. med.R.-E. Bader zum 60. Geburtstag.

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Kieninger, G., Schubert, G.E., Ullmann, U. et al. Die Infektion des Menschen mit Mycobacterium ulcerans (Buruli-Ulkus). Infection 1, 46–52 (1973). https://doi.org/10.1007/BF01638256

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