Etymologia: Buruli Ulcer.

To the Editor: The recent etymologia by Henry in the March 2020 issue of Emerging Infectious Diseases recounts the fascinating origin of the name Buruli ulcer (). Further to the history, in 1948, pathologist Peter MacCallum first described the clinical features for 6 patients from Victoria, Australia, each with an ulcer with undermined edges on an arm or a leg, and the characteristic histopathologic findings, including extensive necrosis and abundant acid-fast bacilli without granuloma formation (). Five of the patients were identified by general practitioners D.G. Alsop, L.E. Clay, and J.R. Searls from the city of Bairnsdale (thus, another eponym “Bairnsdale ulcer”) (). Glen Buckle and Jean Tolhurst at the Alfred Hospital in Melbourne established experimental animal infections, and eventually isolated the causative organism (), which they later named Mycobacterium ulcerans (). The growth of M. ulcerans required prolonged incubation at a temperature of 30°C–33°C (), which was only realized after the inadvertent use of a faulty incubator.

In 1964, Clancey described a “new” mycobacterium causing chronic skin ulcers in Uganda that “resembled” M. ulcerans which he named “Mycobacterium buruli” (). However, the causative organism of Buruli ulcer was subsequently recognized as Mycobacterium ulcerans, which had been originally described in Australia.