32 to 34C Skin Histiocytes Inhibition of phagolysosome fusion Replication

Eyes

Replicates in
Nasal droplets Upper RT
Disseminates in relatively cool
Infected soil Macrophages
blood tissues
Insect vectors
Testes

Peripheral Invasion into Affects transmission of

Demyelination
nerves schwann cells electrical impulses

Nerve injury

Tuberculoid Lepromatous

Paresthesias anhidrosis Loss of sensation

Strong TH1 response TH2 response Weak TH1 response

Production of Production of Low cell mediated

Negative lepromin test
immunity response

IL-2 IFN-y IL-4 IL-10

High microbial burden
Multibacillary
Cytotoxic T cells macrophages NK cells Stimulate B cells

Humoral antibody response

High cell mediated
Positive lepromin test
immunity response
Not protective
Antibodies
Symmetric nerve
involvement
Paucibacillary
Low microbial burden
Complexes with
free antigens Facial nerve paralysis Lagophthalmos Corneal ulceration

Erythema nodosum
Asymmetric Claw fingers Ulnar nerve Glove and stocking Finger amputation
involvement of loss of sensation
large peripheral
vasculitis
nerves Foot drop Peroneal nerve

glomerulonephritis Chronic uveitis

Tender, enlarged
peripheral nerves

Raised, poorly
Rare and demarcated skin
well-demarcated lesions
hypopigmented or
reddish patches

Lumps on face Leonine facies

Foam cells with few

AFB surrounded by
granulomas Hair loss esp.
eyebrows

Treatment
Nasal septum
destruction
Dapsone +
Rifampin +
Clofazamine
For 12 months
Foam cells with
multiple acid fast
bacilli

Treatment

Dapsone +
Rifampin
For 6 months