Other (non-TB) Mycobacteria Flashcards

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1
Q

Which two species of mycobacteria cause leprosy?

A

M. Leprae and M. Lepromatosis

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2
Q

How long is the incubation period for leprosy?

A

2-10 years

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3
Q

How contagious is leprosy?

A

Not very contagious. Requires contact with nasal secretions (respiratory droplet transmission). Only really spreads among those living in poverty.

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4
Q

What is the treatment for leprosy?

A

Rifampicin
Dapsone
Clofazimine (if multibacillary)

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5
Q

What is another name for leprosy?

A

Hansen’s disease

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6
Q

What are the key dermatological manifestations of leprosy?

A
Depigmentation
Macules
Plaques
Nodules
Trophic ulcers
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7
Q

What are the key neurological manifestations of leprosy?

A

Thickened nerves
Sensory neuropathy

Most disability in leprosy is secondary to nerve damage.

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8
Q

What are the key ophthalmic complications of leprosy?

A

Keratitis

Iridocyclitis

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9
Q

What is the key orthopaedic complication of leprosy?

A

Periositis aseptic necrosis

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10
Q

Describe the immunological/clinical spectrum of leprosy.

A

The spectrum has 5 levels, correlating with the level of cell-mediated immunity.

Tuberculoid (TT): high cell-mediated immunity therefore restricted growth of pathogen. Paucibacillary. Th-1 mediated. Depigmented lesions.

Borderline tuberculoid (BT): nerve damage

Borderline (BB): multiple plaques

Borderline lepromatous (BL)

Lepromatous (LL): cell-mediated immunity very ineffective so widespread dissemination of the bacilli. Multibacillary. Th2-mediated. Neuropathic ulcers

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11
Q

Which mycobacteria cause intracellulare infection?

A

M. avium and M. intracellulare (=M. avium intracellulare complex/MAIC)

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12
Q

Name 3 mycobacteria with no person-person transmission

A

M. avium complex
M. marinarum
M. ulcerans

  • associated with environmental transmission eg from other species
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13
Q

How well do the non-TB, non-leprosy mycobacteria respond to standard anti-TB treatment?

A

Not very well, usually poor response

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14
Q

How does M. Avium present in children?

A

Pharyngitis and cervical adenitits

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15
Q

How can M. Avium present in immunocompromised patients?

A

Osteomyelitis

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16
Q

Describe the pulmonary aspects of MAIC infection.

A

Looks like TB. Usually single lobe involvement

17
Q

How does MAIC present in elderly patients?

A

Chronic pulmonary infection

18
Q

How does MAIC present in HIV/AIDS patients?

A

Disseminated multibacillary infection
Mycobacteraemia
Long standing diarrhoea

19
Q

Which mycobacterium causes fish tank granuloma?

A

M. marinarum

20
Q

Describe the dermatological presentation of fish tank granuloma

A

Single or clusters of papules/plaques

21
Q

Which key phrases hint at fish tank granuloma?

A

Patient has some association with swimming pools/aquariums

22
Q

Which mycobacterium causes Buruli ulcers?

A

M. Ulcerans

23
Q

How is M. Ulcerans transmitted?

A

Insect bites, particularly in Australia and the tropics

24
Q

Descibe the progress of a Buruli ulcer

A

Begins as a painless nodule, slowly progresses to ulceration, scarring and contractures. Can cause hideous deformity but seldom fatal.