MYCOBACTERIUM LEPRAE

MOTHER THERESA
Dr.Aravind

M. LEPRAE
Gram positive Acid Fast Leprosy- Hansens disease- Hansens bacilli Aerobic, non-motile, non-spore forming Obligate intracellular parasites- cant be grown in artificial media Infects PNS- anesthetic lesions, skin and mucous memb. Mycoside- phenolglycolipid 1 Can be grown in foot pads of mouse & Armadillo animals
Dr.Aravind

Epidemiology
Tuberculoid Leprosy- no transmission Lepromatous Leprosy- droplet infection Tattoos (via needles) Incubation: 2-7 years Seen in Asian countries Not seen in North America Can seen in Armadillos in Texas and Louisiana.

Dr.Aravind

Pathogenesis (hypothesis)
Infects macrophages & Schwann cells Multiply in #- may inhibit phagosome-lysosome interaction Infection: Schwann cells- anesthetic lesions Tuberculoid Leprosy- can see Granulomas, Cell Mediated Immunity (CMI) v. effective, organisms die, no organism b/c of CMI. Granuloma ->nerve enlargement->damage->loss of sensation (peripheral neuritis) L. Leprosy- CMI-deficient, many organisms, tissues, PNS, over growth of bacteria in cells- damage
Dr.Aravind

Clinical Features
Tuberculoid Leprosy: Macules, flattened, pale- limbs, face, trunk Raised edges, dry, hairless lesion Macule w/long duration- w/o sensation Slow progressive healing After defense mechanism, can see Granulomas w/o organisms

Dr.Aravind

Tubeculoid leprocy
Dr.Aravind

Clinical Features
Lepratomatous Leprosy: CMI is absent See infiltrations in deep tissue & even into blood Lesions are extensive, diffused on face See thickening of skinappear as LION In severe cases, can lose nasal septum, digits Testicular atrophy may occur Patients are shunned due to social stigma

Dr.Aravind

Leprotomatous leprocy
Dr.Aravind

Diagnosis
Acid Fast- scraping of lesions Biopsy- Tuberculoid Leprosy (punch biopsy) Serological test- phenol glycolipid 1 Lepromin Test (sensitivity): T. Leprosy (+)- CMI capacity to restrict disease (Th1 response) L. Leprosy (-)- no defense mechanism (Th2 response)

Dr.Aravind

Treatment
T. Leprosy Dapson, Rifampacin for 6 months L. Leprosy Clofazimine, Rifampacin, & Dapson for 2 years Prevention Early diagnosis & treatment

Dr.Aravind