1 10/20/2015 leprosy filename: leprosy.ppt. 2 10/20/2015 outline n organism n clinical findings n...

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LeprosyLeprosy

Filename:Filename: Leprosy.pptLeprosy.ppt

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OutlineOutline

OrganismOrganism Clinical findingsClinical findings DiagnosisDiagnosis TreatmentTreatment EpidemiologyEpidemiology Prevention and controlPrevention and control

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Mycobacterium lepraeMycobacterium leprae

Unable to cultivateUnable to cultivate Smears & scrapingsSmears & scrapings

– Acid fast rodAcid fast rod– Single, parallel bundles, massesSingle, parallel bundles, masses

IntracellularIntracellular– endothelial cells of blood vesselsendothelial cells of blood vessels– nervesnerves– mononuclear cellsmononuclear cells

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Endothelial cellsEndothelial cells

Grows in the endothelial Grows in the endothelial cells of the blood vesselscells of the blood vessels

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Intracellular Growth in Intracellular Growth in Superficial NervesSuperficial Nerves

NerveNerve

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Experimental modelsExperimental models

MiceMice– Foot padsFoot pads– local granulomatous lesionlocal granulomatous lesion– limited multiplicationlimited multiplication

ArmadilloArmadillo– quadrupletsquadruplets

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Lepromin Skin TestLepromin Skin Test

Analogue of tuberculin testAnalogue of tuberculin test Extract of macular lesionsExtract of macular lesions Inject subdermallyInject subdermally

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Clinical findingsClinical findings

Cooler tissues of Cooler tissues of bodybody– skin, superficial, skin, superficial,

nerves, noses, larynx nerves, noses, larynx eyes and testicleseyes and testicles

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Types of LeprosyTypes of Leprosy

LepromatousLepromatous TuberculoidTuberculoid

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Lepromatous LeprosyLepromatous Leprosy

Progressive but slowProgressive but slow malignmalign nodular skin lesionnodular skin lesion Symmetric nerve involvementSymmetric nerve involvement many acid fast bacillimany acid fast bacilli Positive lepromin testPositive lepromin test

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Tuberculoid LeprosyTuberculoid Leprosy

Non progressiveNon progressive BenignBenign Macular skin lesionsMacular skin lesions Asymmetric nerve involvementAsymmetric nerve involvement Few acid fast bacilliFew acid fast bacilli Lepromin negativeLepromin negative

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Eye InvolvementEye Involvement

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Skin LesionsSkin Lesions

PalePale Macular lesion 1-10 cmMacular lesion 1-10 cm anaestheticanaesthetic

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Neurological involvementNeurological involvement

Nerve infiltration & thickeningNerve infiltration & thickening– anaesthesiaanaesthesia– neuritisneuritis

CausesCauses– Trophic ulcersTrophic ulcers– Bone ReabsorptionBone Reabsorption– shortening of Digitsshortening of Digits

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Trophic ulcersTrophic ulcers

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Bone Bone ReabsorptionReabsorption

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Shortening of DigitsShortening of Digits

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DiagnosisDiagnosis

Clinical findingsClinical findings Scrapings Acid fast bacilliScrapings Acid fast bacilli BiopsyBiopsy

– Nerve involvementNerve involvement Lepromin testLepromin test

Tests for syphilis false positiveTests for syphilis false positive

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TreatmentTreatment

Special sulfonesSpecial sulfones– Dapsone (diaminodiphenylsufone)Dapsone (diaminodiphenylsufone)

RifampinRifampin Long term treatmentLong term treatment

– Months- yearsMonths- years

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EpidemiologyEpidemiology

Mode of transmission ???Mode of transmission ??? Children most susceptibleChildren most susceptible

– Contracted from close family Contracted from close family membersmembers

Very long term incubation periodVery long term incubation period Onset as adultsOnset as adults

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Prevention & ControlPrevention & Control

Separate patients & young children Separate patients & young children in familyin family

Chemotherapy of patients & familyChemotherapy of patients & family BCG vaccinationBCG vaccination

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The EndThe End

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Performance ObjectivesPerformance Objectives

Key terms, concepts Key terms, concepts

short answersshort answers

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Key TermsKey Terms

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Key TermsKey Terms

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Key OrganismsKey Organisms

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Key ConceptsKey Concepts

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Epidemiology of ???Epidemiology of ???

Disease/bacterial factorsDisease/bacterial factors TransmissionTransmission Who is at riskWho is at risk Geography/ seasonGeography/ season IncidenceIncidence Modes of controlModes of control

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Short AnswersShort Answers

Construct a table of the virulence Construct a table of the virulence factors associated with ??? and the factors associated with ??? and the biological activity of eachbiological activity of each

Describe the clinical Describe the clinical manifestations of ???manifestations of ???

Construct a table listing the Construct a table listing the common common ??? ??? species and the species and the associated human diseases.associated human diseases.