Leprosy Filename: Leprosy.ppt.

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Presentation transcript:

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 nerves mononuclear cells

Endothelial cells Grows in the endothelial cells of the blood vessels

Intracellular Growth in Superficial Nerves

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

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

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

Types of Leprosy Lepromatous Tuberculoid

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

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

Eye Involvement

Skin Lesions Pale Macular lesion 1-10 cm anaesthetic

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

Trophic ulcers

Bone Reabsorption

Shortening of Digits

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

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

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

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

The End

Performance Objectives Key terms, concepts short answers

Key Terms

Key Terms

Key Organisms

Key Concepts

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

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.