Coexistence of Mycobacterium ulcerans ssp. shinshuense and Mycobacterium avium in a patient with Buruli ulcer‐compatible lesions

Dear Editor, Buruli ulcer (BU), categorized by the World Health Organization as one of the 20 most neglected tropical diseases, is an infectious disease caused by Mycobacterium ulcerans. BU is rare in Japan and differs from conventional BU in that it is caused by M. ulcerans ssp. shinshuense. We report a case of BU-compatible lesions exhibiting coexistence of M. ulcerans ssp. shinshuense and Mycobacterium avium. A 29-year-old Japanese man from the city of Himeji was admitted to our hospital with painful ulcers on the right ankle,