Leprosy N Actinomycosis

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its a lecture of 2nd mbbs students which i have taken in last week.. hope u will enjoy it

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Leprosy N Actinomycosis

  1. 2. Examples of Chronic Inflammation <ul><li>Tuberculosis </li></ul><ul><li>Leprosy, Syphilis , Cat scratch disease, Granuloma inguinale, Tularemia </li></ul><ul><li>Fungal- Actinomycosis, Blastomycosis, Cryptococosis </li></ul><ul><li>Parasitic- Schistosomiasis </li></ul><ul><li>Sarcoidosis, Crohns, Foreignbody. </li></ul>
  2. 3. ? The Organism? How it enters in the body? Which organs are affected? Changes in the organs, Gross & Microscopy Complications and fates of disease How to make a Diagnosis ?
  3. 4. <ul><li>Leprosy ~ </li></ul><ul><li>Hansen’s disease </li></ul>
  4. 5. <ul><li>Mycobacterium leprae </li></ul><ul><li>less acid fast . </li></ul>
  5. 6. <ul><li>Transmission </li></ul><ul><li>Slow communicable </li></ul><ul><li>Incubation period – 3 yrs </li></ul>Slow transmission
  6. 7. <ul><li>Route : </li></ul><ul><li>‘ Direct contact’ </li></ul>
  7. 8. <ul><li>Organs involved </li></ul>
  8. 9. Classification <ul><li>Lepromatous </li></ul><ul><li>Tuberculoid </li></ul>
  9. 10. <ul><li>T Lymphocytes </li></ul><ul><li>IFN-Gamma </li></ul><ul><li>Macrophages </li></ul><ul><li>epitheloid </li></ul><ul><li>giant cells . </li></ul>
  10. 11. Modified Ridley & Jopling’s classification
  11. 12. <ul><li>TT – Tuberculoid polar </li></ul><ul><li>BT – Borderline tuberculoid </li></ul><ul><li>TI -- Tuberculoid indeinite </li></ul><ul><li>BB – Mid borderline </li></ul><ul><li>LI – Lepromatous indefinite </li></ul><ul><li>BL – Borderline lepromatous </li></ul><ul><li>LL – Lepromatous polar </li></ul>
  12. 13. <ul><li>Other types: </li></ul><ul><li>Pure neural </li></ul><ul><li>Histoid </li></ul><ul><li>Indeterminate </li></ul>
  13. 14. Lepromatous leprosy Symmetrical, Multiple, Hypopigmented lesions Leonine faces Pts Immunity – down Sensory deficit – less severe
  14. 16. Histology <ul><li>Foamy cells in the dermis, </li></ul><ul><li>separated from Epidermis </li></ul><ul><li>by Clear zone </li></ul>
  15. 18. Tuberculoid leprosy <ul><li>Single or few asymmetrical , </li></ul><ul><li>Sensory impairment </li></ul><ul><li>Histology </li></ul><ul><li>Tubercle, </li></ul><ul><li>dermal nerves, </li></ul><ul><li>No clear zone, few bacilli </li></ul>
  16. 20. Lab Diagnosis <ul><li>To show the organism </li></ul><ul><li>Skin clipping </li></ul><ul><li>Stains- </li></ul><ul><li>ZN, Fite Faraco, </li></ul><ul><li>Gomori methenamine silver </li></ul>
  17. 21. <ul><li>Culture </li></ul>
  18. 22. 9 Banded Armadilo
  19. 24. Reactions in Leprosy <ul><li>Lepra type I </li></ul><ul><li>Lepra type II </li></ul>
  20. 25. Lepra type I <ul><li>Upgrading reaction </li></ul><ul><li>Downgrading reaction </li></ul>
  21. 26. <ul><li>TT – Tuberculoid polar </li></ul><ul><li>BT – Borderline tuberculoid </li></ul><ul><li>TI -- Tuberculoid indeinite </li></ul><ul><li>BB – Mid borderline </li></ul><ul><li>LI – Lepromatous indefinite </li></ul><ul><li>BL – Borderline lepromatous </li></ul><ul><li>LL – Lepromatous polar </li></ul>
  22. 27. Lepra type 2 <ul><li>Erythema nodosum Leprosum </li></ul><ul><li>In Lepromatous patient </li></ul><ul><li>after treatment </li></ul><ul><li>Tender nodules, fever, synovitis, </li></ul><ul><li>Lymphnode enlargement </li></ul>
  23. 28. Lepromin test
  24. 31. <ul><li>Not </li></ul><ul><li>for Diagnosis </li></ul>
  25. 32. <ul><li>For classifying Leprosy </li></ul><ul><li>Depending on immune response . </li></ul><ul><li>24-48 Fernandez </li></ul><ul><li>3-4 wks Mitsuda reaction </li></ul>
  26. 34. Baba Amte
  27. 37. Actinomycosis
  28. 38. <ul><li>Mycosis… </li></ul><ul><li>Is it a fungus? </li></ul><ul><li>No </li></ul>
  29. 39. <ul><li>Anaerobic B acteria </li></ul><ul><li>Actinomycetes israelii. </li></ul><ul><li>Commensal organism. </li></ul><ul><li>Endogenous infection. </li></ul>
  30. 40. Types depending on sites <ul><li>Cervicofacial </li></ul><ul><li>Thoracic </li></ul><ul><li>Abdominal </li></ul><ul><li>Pelvic </li></ul>

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