First case of Mycobacterium ulcerans disease (Buruli ulcer) following a human bite. Clin Infect Dis 36: e67–e68

Mycobacterium ulcerans disease (MUD) is rapidly reemerging in many countries, especially in West African countries. An-tecedent trauma has often been related to the lesions that characterize this frequently crippling disease. We report here the first case of MUD that followed a human bite at the site where the lesion later occurred. Human bites are common among children and occur most frequently on an upper extremity. More than 40 species of bacteria have been isolated from wounds caused by human bites. Other specific infections and diseases associated with hu-man bites include herpes simplex, cytomegalovirus, hepatitis B and C, HIV, syphilis, tuberculosis, actinomycosis, and tetanus [1]. This is the first report of Mycobacterium ulcerans disease (MUD; also known as “Buruli ulcer”) related to a human bite. Case report. A 13-year-old girl from Bonou (Ouéme De-partment, Benin) presented with an extensive induration on the entire right forearm and the dorsum of the right hand. There was only slight ulceration, and the lesion was typical of the plaque form of early disseminated MUD. The patient was otherwise healthy, with normal results of routine laboratory tests. Approximately 30 days previously, a playmate had bitten the patient on the same forearm. The lesion associated with MUD was excised from the elbow to the hand within 24 h after admission, and a skin graft was performed 2 weeks later. Th