1
04/20/23
LeprosyLeprosy
Filename:Filename: Leprosy.pptLeprosy.ppt
2
04/20/23
OutlineOutline
OrganismOrganism Clinical findingsClinical findings DiagnosisDiagnosis TreatmentTreatment EpidemiologyEpidemiology Prevention and controlPrevention and control
3
04/20/23
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
4
04/20/23
Endothelial cellsEndothelial cells
Grows in the endothelial Grows in the endothelial cells of the blood vesselscells of the blood vessels
5
04/20/23
Intracellular Growth in Intracellular Growth in Superficial NervesSuperficial Nerves
NerveNerve
6
04/20/23
Experimental modelsExperimental models
MiceMice– Foot padsFoot pads– local granulomatous lesionlocal granulomatous lesion– limited multiplicationlimited multiplication
ArmadilloArmadillo– quadrupletsquadruplets
7
04/20/23
Lepromin Skin TestLepromin Skin Test
Analogue of tuberculin testAnalogue of tuberculin test Extract of macular lesionsExtract of macular lesions Inject subdermallyInject subdermally
8
04/20/23
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
9
04/20/23
Types of LeprosyTypes of Leprosy
LepromatousLepromatous TuberculoidTuberculoid
10
04/20/23
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
11
04/20/23
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
12
04/20/23
Eye InvolvementEye Involvement
13
04/20/23
Skin LesionsSkin Lesions
PalePale Macular lesion 1-10 cmMacular lesion 1-10 cm anaestheticanaesthetic
14
04/20/23
Neurological involvementNeurological involvement
Nerve infiltration & thickeningNerve infiltration & thickening– anaesthesiaanaesthesia– neuritisneuritis
CausesCauses– Trophic ulcersTrophic ulcers– Bone ReabsorptionBone Reabsorption– shortening of Digitsshortening of Digits
15
04/20/23
Trophic ulcersTrophic ulcers
16
04/20/23
Bone Bone ReabsorptionReabsorption
17
04/20/23
Shortening of DigitsShortening of Digits
18
04/20/23
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
19
04/20/23
TreatmentTreatment
Special sulfonesSpecial sulfones– Dapsone (diaminodiphenylsufone)Dapsone (diaminodiphenylsufone)
RifampinRifampin Long term treatmentLong term treatment
– Months- yearsMonths- years
20
04/20/23
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
21
04/20/23
Prevention & ControlPrevention & Control
Separate patients & young children Separate patients & young children in familyin family
Chemotherapy of patients & familyChemotherapy of patients & family BCG vaccinationBCG vaccination
22
04/20/23
The EndThe End
23
Performance ObjectivesPerformance Objectives
Key terms, concepts Key terms, concepts
short answersshort answers
24
04/20/23
Key TermsKey Terms
25
04/20/23
Key TermsKey Terms
26
04/20/23
Key OrganismsKey Organisms
27
Key ConceptsKey Concepts
28
04/20/23
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
29
04/20/23
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.