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Home / Equine Research Bank / Equine Vet J / Cutaneous non-tuberculous Mycobacterium ulcerans infection: ...
Equine veterinary journal2025; doi: 10.1111/evj.14501

Cutaneous non-tuberculous Mycobacterium ulcerans infection: A serious cause for concern.

Abstract: Mycobacterium ulcerans infection in horses is under-reported. Objective: To document the successful multimodal treatment of M. ulcerans and highlight the need for further investigation due to the zoonotic nature of M. ulcerans with its related potential public health concerns. Methods: Case report CASE DESCRIPTION: A 14-year-old gelding in the Southeastern region of Australia was diagnosed with M. ulcerans infection, initially presenting as a non-healing wound of the right flank progressing to extensive necrotic ulceration. Ziehl-Neelsen and Wade-Fite stained incisional biopsies revealed large numbers of intralesional acid-fast bacilli predominantly within the areas of necrosis, supportive of M. ulcerans infection. Real-time PCR confirmed the presence of mycobacteria. The close relationship between M. ulcerans and M. marinum meant that PCR was unable to distinguish these species. Due to the equine host and non-aquatic environment, there was a presumptive diagnosis of M. ulcerans. Multimodal treatment involving surgical debridement, biological debridement with maggots, cryosurgery, systemic antimicrobials, and analgesia was applied in a singular case of necrotising M. ulcerans. The horse had made a full recovery at the time of publication. Conclusions: A single case is described. Conclusions: Infection with M. ulcerans should be considered in necrotising soft-tissue lesions in regions where the organism is endemic. This case report highlights the need for specific staining and rapid PCR testing. A combination of antimicrobial therapy, surgical debridement and biological debridement with maggot therapy led to a successful outcome. In temperate or tropical regions, M. ulcerans infection should be considered as part of the differential diagnosis for necrotising, nonhealing, ulcerative lesions. A better understanding of the epidemiology and mode of transmission is essential to improve our ability to prevent, control, and potentially eliminate this pathogen.
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Publication Date: 2025-03-24 PubMed ID: 40123448DOI: 10.1111/evj.14501Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The article reports a successful case of treating Mycobacterium ulcerans infection in a horse and highlights the need for more research into the disease due to its potential public health risks.

Objective and Methods

  • The objective of the study was to document the treatment of Mycobacterium ulcerans infection in horses and to emphasize the need for further research due to the potential risk it poses to public health.
  • The authors conducted a case study on a 14-year-old gelding from Southeast Australia that was diagnosed with Mycobacterium ulcerans infection.

Case Description and Diagnosis

  • The horse initially presented with a non-healing wound on its right flank that progressed to extensive necrotic ulceration.
  • Diagnosis was made by examining incisional biopsies stained with Ziehl-Neelsen and Wade-Fite techniques which revealed several intracellular acid-fast bacilli, characteristics of M. ulcerans infection.
  • The presence of mycobacteria was further confirmed by real-time PCR but there was inability to distinguish between M. ulcerans and M. marinum due to their close relationship.
  • With the discipline of the horse being a non-aquatic animal and the environment, a presumptive diagnosis of Mycobacterium ulcerans was made.

Treatment

  • A multimodal treatment approach was used to address the M. ulcerans infection, which included surgical debridement, biological debridement with maggots, cryosurgery, systemic antimicrobials, and analgesia.
  • At the time of article’s publication, the horse had fully recovered.

Conclusions and Recommendations

  • The article concludes with a note that M. ulcerans infection should be considered in cases of necrotizing soft-tissue lesions in regions where the organism is endemic.
  • This case study emphasized the importance of specific staining and rapid PCR testing in diagnosing this type of infection.
  • The authors recommend a combination of antimicrobial therapy, surgical debridement and biological debridement with maggot therapy for successful treatment outcomes.
  • The authors also suggest that a better understanding of the epidemiology and transmission of M. ulcerans is crucial to improve prevention and control measures, and potentially eliminate this pathogen.

Cite This Article

APA
Bain ME, Alsop EJ, Knox CA, Tweedie MA, Knottenbelt DC. (2025). Cutaneous non-tuberculous Mycobacterium ulcerans infection: A serious cause for concern. Equine Vet J. https://doi.org/10.1111/evj.14501

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English

Researcher Affiliations

Bain, Melissa E
  • Tweedie & Associates Equine Veterinary Services, Moorooduc, Victoria, Australia.
Alsop, Emma J
  • Equine Medical Solutions, Stirling, UK.
Knox, Caley A
  • Tweedie & Associates Equine Veterinary Services, Moorooduc, Victoria, Australia.
Tweedie, Michael A
  • Tweedie & Associates Equine Veterinary Services, Moorooduc, Victoria, Australia.
Knottenbelt, Derek C
  • Equine Medical Solutions, Stirling, UK.

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