Leprosy (Hansen's Disease

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1
What is leprosy also known as?
Hansen's Disease
2
CO:
Mycobacterium leprae
3
Classification of Mycobacterium leprae?
*gram positive rod (GPR)
*acid fast
*aerobic (needs O2)
*obligate intracellular parasite
4
What type of cells do Mycobacterium leprae invade?
Schwann cells (associated with peripheral neurons)
macrophages of skin cells
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What is doubling time of Mycobacterium leprae?
11-13 days
6
R:
Armadillos, Humans
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POI:
Skin, Mucosa, upper respiratory tract
8
MOT:
all likely
-respiratory droplets
-direct skin contact
-zoonotic
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Pathogenesis:
*bacteria invents skin cells macrophages and periphernal nerves (colder extremities)
*immune response leads to development of tubercles and/or tissue/nerve damage/loss
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What does tissue damage from bacteria lead to? (pathogenesis)
*nerve damage (loss of sensory perception)
*non-inflammatory cell death
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incubation period?
3 months-20 yrs
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What types of skin lesions associated?
*hypopigmented
*raised flat, dry and scaly, red patches
*reversal rx also possible (plaques with red border)
*numbness
*painless ulcers
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Complications?
*nerve damage
*paralysis
*deformaties (clawed hand)
*tissue necrosis
*corneal ulcers
*bone loss (digit resorption)
*infertility
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Average incubation period?
*5 years, asymptomatic
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Prevention for leprosy? Efficacy?
*avoid contact with infected individuals/animals
*Tuberculosis (BCG) vaccine (32-86% effective)
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Treatment for Leprosy? Be specific with mechanism of action and duration:
*multiple antibiotic therapy (6-12 months)
-rifampin (rna polymerase inhibitor)
-dapsone (sulfanamide/metabolism inhibitor)
-clofazimine
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