Leprosy Flashcards

1
Q

Can M. Lepri be cultured?

A

No

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2
Q

What is the cardinal finding of Leprosy?

A

Skin rash with Anesthesia. It is 70-80% sensitive.

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3
Q

What other methods are used to diagnose Leprosy?

A

Skin slit on ears, elbows, knees, depth of paper cut without blood placing fluid on a slide
Nasal fluid
5 mm skin bx.
Sural N. Bx.

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4
Q

Is leprosy found in any other creatures?

A

The 9 band armadillo

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5
Q

What is the incubation period of Leprosy?

A

Up to 20 years.

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6
Q

What percentage of humans are susceptible to this organism?

A

3 to 5%

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7
Q

How is the organism transmitted?

A
Nasal Droplets- up to 40,000,000 orgs. per day
Direct contact with open ulcers
Breast Milk
Blood Products
Tatooing
Thorns
Soil
Transplacental in Armadillos
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8
Q

How many days of RIfampin will eliminate transmission?

A

3 along with hand washing

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9
Q

What physical findings are associated with Leprosy?

A
Nasal Congestion
Nose Bleeds
Nasal Septal Perforation
Loss of Eyebrows- Madurosis
Uveitis
Exposure Keratitis
Erythema Nodosum
Enlarged and thickened Peripheral Nerves
Leonine Facies
Fish Mouth Deformity
Mega Ear Lobes
Nasal Distortion
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10
Q

What are some diagnostic indices?

A
Bacillary Index- #of orgs/hpf- logarithmic scale
Ridley-Joplin Staging for 5 mm punch bx
Genetic markers via PCR:
  Folpi mutation- Dapsone resistant
  rpoB-Rifampin resistant
  gyrA mutation- Quinolone resistant
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11
Q

What are the clinical syndromes of Leprosy?

A
Indeterminate
Tuberculoid
Borderline Tuberculoid
Borderline
Borderline Lepromatous
Lepromatous
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12
Q

What are the two classifications for the treatment of Leprosy?

A

Paucibacillary

Multibacillary

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13
Q

What syndromes of Leprosy are the paucibacillary type?

A

Intermediate
Tuberculoid
Borderline Tuberculoid

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14
Q

What syndrome of Leprosy are multibacillary?

A

Borderline
Borderline Lepromatous
Lepromatous

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15
Q

What is the treatment of paucibacillary Leprosy?

A

Rifampin and Dapsone for 12 months

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16
Q

What is the treatment of multibacillary Leprosy?

A

Rifampin, Dapsone and Clofazimine for 24 months

17
Q

What is a reversal reaction?

A

Type I reaction of inflammation with upgrading reaction in BT, BB and BL. Look for an angry edge which is warm to touch. The treatment is Prednisone tapered over months

18
Q

What is the Lucio Phenomenon?

A

Necrotic vasculitis

19
Q

What is Erythema Nodosum?

A

a type 2 reaction in BL and LL.New nodules in nl. skin.. Treated with Thalidomide followed by a taper