Sketchy Micro: Mycobacterium Leprae

Question 1

M. leprae thrives in ___________.

Answer 1

cool temperatures

Note: this is why M. leprae likes the extremities.

(Hence, this Sketch takes place in winter with icicles hanging off the jail.)

Question 2

M. leprae is a _____________ bacteria.

Answer 2

acid-fast

Think of the cowboy’s mycolic-acid tassels.

Question 3

Leprosy is also called _____________.

Answer 3

Hansen’s disease

Question 4

In the U.S., the main reservoir for M. leprae is ________________.

Answer 4

armadillos (represented by the Armadillo County Jail sign and the little armadillo next to the gunslinger)

Question 5

Describe the body’s two responses to M. leprae.

Answer 5

• Tuberculin: a strong Th1 response leads to the body trapping M. leprae inside macrophages
- Symptoms include bald spot

(Think of the #1 jail on the left with the bald man in the cage.)

•Lepromatous: a Th2 response allows the bacteria to escape from the macrophages

(Think of the guy in jail cell #2 escaping from the cage.)

Question 6

Th2 cells promote the __________ response.

Answer 6

humoral

Question 7

What symptoms are typical of the lepromatous response to M. leprae?

Answer 7

• Glove and stocking neuropathy
• Raised red lesions on the extension surfaces with irregular borders
• Leonine facies

(Think of the black gloves and socks on the escaping convict and the patches on his long johns; the gunslinger is wearing a lion bandana.)

Question 8

Biopsy of ___________ lesions will show more bacteria.

Answer 8

lepromatous (because lepromatous lesions are less contained)

Question 9

How should each presentation of M. leprae infection be treated?

Answer 9

• Tuberculin: dapsone and rifampin (the DePuty has a RIFle pointed at the guy in #1)
• Lepromatous: dapsone, tuberculin, and clofazimine (the same as the tuberculin treatment but with clofazimine added; think of the CLOth escape rope in the second jail)