Exam Study Guide - Leprosy, Tuberculosis, Syphilis

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26 Feb 2011
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Department
Course
Leprosy (Hansenโ€™s disease)
History
๎€1550BC Egyptian Papyrus document
๎€Approx. 600BC Indian writings
๎€320BC Records in Ancient Greece, after army of Alexander the Great returned from
India
๎€62BC - Rome returned with Pompeiiโ€™s troops from Asia Minor
๎€Disease of soul
๎€Thought to be hereditary illness, caused by a curse or punishment of God
๎€Lepers were stigmatized โ€“ special clothing, arrival notification, separate hospitals,
leprosariums/lazaretto/leper colony/lazar house
๎€936AD England - First โ€˜leper houseโ€™
๎€Mid-12th century โ€“ loss of civic status removal from public office;
๎€13th century - 19,000 โ€˜leprosariaโ€™ in use
๎€Mass of Separation
๎€Decline around 1350 AD
๎€Spread to North America
Dr. Armauer Hansen of Norway โ€“ 1873
๎€Discovers the leprosy germ under a microscope
๎€Mycobacterium leprae (M. leprae )
Etiology
๎€Slow multiplying bacillus
- average doubling time of 12 โ€“ 14 days
๎€Incubation period of 3 โ€“ 5 yrs
๎€Thought to be transmitted via droplets, from the nose during close and frequent
contact
๎€Not highly infectious โ€“ may be related to genetic susceptibility
๎€Mainly affects the skin, nerves, and mucous membranes
Risk
๎€All races;
๎€common in warm, wet areas in the tropics and subtropics;
๎€Most susceptible between the ages of 10 and 14 years old, 35-44 years old
๎€Rarely seen in infants; Genetic susceptibility
Diagnosis and Treatment
๎€Based on clinical symptoms; laboratory studies
๎€Chaulmoogra nut
๎€promin (1941)
๎€Dapsone (1950s)
๎€WHO recommends multidrug therapy (MDT) โ€“ dapsone, rifampicin, clofazimine
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Nine-banded armadillo
๎€Do not develop human type leprosy, usually more severe and fatal;
๎€low body temperature (28-33C) may promote disease;
๎€mid-1980s concern of infection from armadillos
Prevention โ€“ hand washing; disinfection of fomites, handkerchiefs; nasal secretions;
household contacts (young - treat with drugs); vaccine
Possible causal factors for the disappearance of disease
๎€Selective mortality of leprosy patients during plague pandemic
๎€Cross-immunity with other Mycobacteria
๎€Loss of pathogenecity
๎€Genetic selection of the population
๎€Improved quarantine
๎€Improved socio-economic conditions
๎€Better housing and sanitation
๎€Climate
Indeterminate
Leprosy (IL)Tuberculosis
Leprosy (TT)Borderline
Tuberculoid
Leprosy (BT)
Borderline
Lepromatous
Leprosy (BL)
Lepromatous Leprosy
(LL)
-earliest, mildest
form
-usually few
lesions
-loss of sensation
is rare
-development of
large lesions
-loss of sensation
-affected nerves
become thick
-progression can
occur to BT
-lesions are
smaller and
more numerous
-lesions are more
numerous, but
they may also
consist of papules,
plaques, and
nodules
-punched-out-
appearing lesions
that look like
inverted saucers
are common
-the disease may
remain at this
stage
-never reverts to a less severe
form
-early symptoms: nasal
stuffiness, discharge and
bleeding, and swelling of the
legs and ankles
-other problems: skin
thickens; eyebrows and
eyelashes lost; nose
deformation or collapses; ear
lobes thicken; photophobia
(light sensitivity); blindness;
enlarged liver and lymph
nodes; hoarseness in voice;
fingers and toes become
deformed
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Document Summary

320bc records in ancient greece, after army of alexander the great returned from. 62bc - rome returned with pompeii"s troops from asia minor. Thought to be hereditary illness, caused by a curse or punishment of god. Lepers were stigmatized special clothing, arrival notification, separate hospitals, leprosariums/lazaretto/leper colony/lazar house. mid-12th century loss of civic status removal from public office; discovers the leprosy germ under a microscope. Average doubling time of 12 14 days. Thought to be transmitted via droplets, from the nose during close and frequent contact. not highly infectious may be related to genetic susceptibility. mainly affects the skin, nerves, and mucous membranes. Risk common in warm, wet areas in the tropics and subtropics; most susceptible between the ages of 10 and 14 years old, 35-44 years old. who recommends multidrug therapy (mdt) dapsone, rifampicin, clofazimine promin (1941) www. notesolution. com. do not develop human type leprosy, usually more severe and fatal;

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