M.ulcerans infection occurs at sites of traumatic inoculation, usually the legs, resulting in large to gigantic deep painless ulcerations, occurring in tropical regions of Africa and Australia.
The infection is transmitted from the environment to people by unknown mechanism. Mycobacterium Ulcerans is not spread from person to person.
* The infection generally starts as a small spot attached to the skin resembling a mosquito bite that enlarges over days to weeks.
* Acute swelling of the whole limb.
* A nodule beneath the skin may be the first sign.
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