Could possum bites be spreading Buruli ulcer?

A patient in south-east Victoria presented to his GP with a lesion on his finger six months after being bitten by a 'sickly' possum
Lesion before beginning rifampicin and clarithromycin (A). Paradoxical flare of pain and swelling midway through antibiotic course (B).

Clinicians are reporting the case of a Victorian patient they believe contracted Buruli ulcer from a possum bite, rather than through an infected mosquito.

The previously well 81-year-old presented to his GP with a shallow, red ulcer on the dorsum of his left index finger.

It had started three weeks earlier with induration, erythema and minor pain.

The patient told the GP the ulcer was in the exact spot where he had been bitten by a ringtail possum six-months earlier in his garden on the Mornington Peninsula in south‐east Victoria.