Leprosy

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1
Disease Classification
Leprosy- Hansen’s Disease
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Causative Organism
Myobacterium leprae
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GTKYCA
GPR, Acid-fast, Aerobic, 11-13 day doubling time, can’t be easily cultured, obligate intracellular parasite, invades schwann cells associated with peripheral neurons
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Epidemiology: Reservoir
Armadillos, Humans
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Epidemiology: POE
Skin, Mucosa, Upper Respiratory Tract
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Epidemiology: MOT
(ALL likely) Respiratory droplets, direct skin contact, zoonotic
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Incubation Period
3 months- 20 yrs
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Pathogenesis
Bacteria infect skin cells macrophages and peripheral nerves of cooler extremitis. Immune responses can result in tubercle formation and/or tissue damage or loss- including nerve damage and loss of sensory perception. Tissue damage results from non-inflammatory cell death
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Symptoms
Asymptomatic; Incubation 5 yr average; Skin lesions, Numbness, Painless ulcers
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Skin lesions apperance
hypopigmented, raised flat red patches, dry, scaley, reversal reactions (plaques with a red border)
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Complications
Nerve damage, paralysis, deformitis such as clawed hand, tissue necrosis, corneal ulcers, bone loss (digit resorption), infertility
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Prevention
Avoid contacting infected animals, tuberculosis (BCG) vaccine (possibly 32-86% effective)
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Treatment
Multiple Antibiotic Therapy (6-12 month); rifampin, dapsone, clofazimine
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