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Leprosy

Leprosy. Filename: Leprosy.ppt. Outline. Organism Clinical findings Diagnosis Treatment Epidemiology Prevention and control. Mycobacterium leprae. Unable to cultivate Smears & scrapings Acid fast rod Single, parallel bundles, masses Intracellular endothelial cells of blood vessels

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Leprosy

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  1. Leprosy Filename:Leprosy.ppt

  2. Outline • Organism • Clinical findings • Diagnosis • Treatment • Epidemiology • Prevention and control

  3. Mycobacterium leprae • Unable to cultivate • Smears & scrapings • Acid fast rod • Single, parallel bundles, masses • Intracellular • endothelial cells of blood vessels • nerves • mononuclear cells

  4. Endothelial cells • Grows in the endothelial cells of the blood vessels

  5. Intracellular Growth in Superficial Nerves Nerve

  6. Experimental models • Mice • Foot pads • local granulomatous lesion • limited multiplication • Armadillo • quadruplets

  7. Lepromin Skin Test • Analogue of tuberculin test • Extract of macular lesions • Inject subdermally

  8. Clinical findings • Cooler tissues of body • skin, superficial, nerves, noses, larynx eyes and testicles

  9. Types of Leprosy • Lepromatous • Tuberculoid

  10. Lepromatous Leprosy • Progressive but slow • malign • nodular skin lesion • Symmetric nerve involvement • many acid fast bacilli • Positive lepromin test

  11. Tuberculoid Leprosy • Non progressive • Benign • Macular skin lesions • Asymmetric nerve involvement • Few acid fast bacilli • Lepromin negative

  12. Eye Involvement

  13. Skin Lesions • Pale • Macular lesion 1-10 cm • anaesthetic

  14. Neurological involvement • Nerve infiltration & thickening • anaesthesia • neuritis • Causes • Trophic ulcers • Bone Reabsorption • shortening of Digits

  15. Trophic ulcers

  16. Bone Reabsorption

  17. Shortening of Digits

  18. Diagnosis • Clinical findings • Scrapings Acid fast bacilli • Biopsy • Nerve involvement • Lepromin test Tests for syphilis false positive

  19. Treatment • Special sulfones • Dapsone (diaminodiphenylsufone) • Rifampin • Long term treatment • Months- years

  20. Epidemiology • Mode of transmission ??? • Children most susceptible • Contracted from close family members • Very long term incubation period • Onset as adults

  21. Prevention & Control • Separate patients & young children in family • Chemotherapy of patients & family • BCG vaccination

  22. The End

  23. Performance Objectives Key terms, concepts short answers

  24. Key Terms

  25. Key Terms

  26. Key Organisms

  27. Key Concepts

  28. Epidemiology of ??? • Disease/bacterial factors • Transmission • Who is at risk • Geography/ season • Incidence • Modes of control

  29. Short Answers • Construct a table of the virulence factors associated with ??? and the biological activity of each • Describe the clinical manifestations of ??? • Construct a table listing the common ??? species and the associated human diseases.

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