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Buruli Ulcer — RACP Paediatrics MCQ

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HardInfectious DiseaseBuruli UlcerRACP Paediatrics

A 10-year-old presents with a painless papule that has developed into a chronic ulcer with rolled edges on his arm. He recently returned from a trip to the Northern Territory (Top End). Biopsy shows granulomatous inflammation. Ziehl-Neelsen stain is positive. What is the diagnosis?

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Correct answer: D — Buruli ulcer (M. ulcerans, Daintree ulcer/Bairnsdale ulcer)

Buruli ulcer (Mycobacterium ulcerans) is endemic in parts of Australia (particularly the Bellarine Peninsula in Victoria and the Daintree region in Queensland). It presents as a painless papule that ulcerates with undermined edges. Diagnosis is by PCR and ZN stain. Treatment is combination antibiotics (rifampicin + clarithromycin for 8 weeks).

Reference: Therapeutic Guidelines – 2024 – Antibiotic: Mycobacterium ulcerans