MyMedR

The bacillus leprae: has it been cultivated?

Fraser H, Fletcher W

Lancet, 1913;182:918-21.

DOI: 10.1016/S0140-6736(01)77220-0

Matched MeSH terms: Mycobacterium leprae

The epidemiology of leprosy

Lowe J

Journal of the Malaya Branch of the British Medical Association, 1937;1:56-61.

Matched MeSH terms: Mycobacterium leprae

Fulltext Serum antibodies to defined carbohydrate antigens during the course of treated leprosy

Gelber RH, Li F, Cho SN, Byrd S, Rajagopalan K, Brennan PJ

Int. J. Lepr. Other Mycobact. Dis., 1989 Dec;57(4):744-51.

PMID: 2681457

Sequential monitoring of 724 sera for antibodies to a neoantigen based on phenolic glycolipid-I (PGL-I) and native lipoarabinomannan (LAM) in 90 leprosy patients undergoing therapy in San Francisco was conducted. Untreated lepromatous patients frequently (91%) had significant antibodies to both moieties. Antibodies were less frequently found in tuberculoid patients (74% to neoantigen and 37% to LAM). In the first 3 years of treatment, average serum antibodies to both moieties fell significantly. Antibodies to LAM fell during each of the first 4 years of therapy, but decreasing antibody levels to the PGL-I neoantigen did not appear to fall consistently after the third year of treatment. A wide variation in the rate of fall of serum antibodies was noted. Sequential changes in the amounts of serum antibodies to the neoantigen and LAM in general paralleled one another but were at times discrepant. Both in San Francisco and Malaysia, skin-smear negative, long-term treated, lepromatous leprosy patients frequently harbored significant antibodies to both PGL-I and LAM.

Matched MeSH terms: Mycobacterium leprae/immunology*

Pediatric leprosy in Sarawak, Malaysia

Bin Yap FB

Pediatr Infect Dis J, 2009 Oct;28(10):933-4.

PMID: 20118691 DOI: 10.1097/INF.0b013e3181b48f76

Matched MeSH terms: Mycobacterium leprae/classification; Mycobacterium leprae/isolation & purification*

The status of leprosy control in Malaysia

Sukumaran KD

Southeast Asian J. Trop. Med. Public Health, 1988 Sep;19(3):519-24.

PMID: 3064325

Matched MeSH terms: Mycobacterium leprae/immunology

Mycobacterium leprae reactive T cell clones from lepromatous leprosy patients after prolonged dapsone chemotherapy

Gill HK, Ridley DS, Ganesan J, Mustafa AS, Rees RJ, Godal T

Lepr Rev, 1990 Mar;61(1):25-31.

PMID: 2181222

The proliferative responses of peripheral blood mononuclear cells (PBMC) to Mycobacterium leprae and BCG were studied in two groups of leprosy patients: a group of 8 lepromatous patients who had been on treatment for more than 20 years (TLL) and a group of 8 untreated lepromatous leprosy patients (ULL). The mean response to M. leprae of the TLL group was 6195 cpm with 5 of the 8 patients responding positively. The mean response to M. leprae of the ULL group was 617 cpm, with only 1 patient showing a positive response. The corresponding proliferative responses to BCG were 19,908 cpm in the TLL group and 7908 in the ULL group. Thirteen M. leprae reactive clones were established from 2 TLL patients and 5 M. leprae reactive clones were established from 2 tuberculoid leprosy patients. Seven of these clones, 4 from the TLL patients and 3 from the tuberculoid (TT) patients could be studied further. Three of the TLL clones responded specifically to M. leprae, while one of the clones exhibited a broad cross-reactivity to other mycobacteria. All of these clones were of the CD4+CD8- phenotype. Our findings suggest that responsiveness to M. leprae can be detected in vitro in a proportion of LL patients who have undergone prolonged chemotherapy, and that this response involves M. leprae reactive CD8+CD8- T cells, of which some appear to be specific to M. leprae.

Matched MeSH terms: Mycobacterium leprae/immunology*

Fulltext Chemotherapeutic trials in leprosy. 7. Trial of 50 mgm. DDS twice weekly in the treatment of lepromatous leprosy

Pearson JMH, Pettit JHS

Int. J. Lepr. Other Mycobact. Dis., 1969;37(1):40-5.

PMID: 4897238

Fifteen patients with pure lepromatous leprosy were treated for 12 months with DDS at 50 mgm. twice weekly. The drug was fully effective in this dose, and the incidence and severity of ENL were not less than on larger doses

Matched MeSH terms: Mycobacterium leprae/isolation & purification

Fulltext Chemotherapeutic trials in leprosy. 6. Pilot study of the riminophenazine derivative B.663 in low dosage (100 mgm. twice weekly) in the treatment of lepromatous leprosy

Waters MFR

Int. J. Lepr. Other Mycobact. Dis., 1968;36(4):391-9.

PMID: 4898403

Using a trial design previously evolved at Sungei Buloh Leprosarium, a pilot trial was performed of B.663, in the dosage of 100 mgm. twice weekly, in eight patients with previously untreated lepromatous leprosy. The therapeutic results, as measured by clinical, bacteriologic and histologic assessment, and especially by the rate of fall of the morphologic index, were similar to those obtained with sulfone therapy or with 0.663 in the dosage of 300 mgm. daily. Although B.663 pigmentation was produced in all eight patients, it developed more slowly and was less intense than with standard dosage. Difficulties resulting from skin discoloration in assessing the clinical progress of patients on B.663 are discussed.

Matched MeSH terms: Mycobacterium leprae/drug effects

Dapsone alone compared with dapsone plus rifampicin in short-term therapy of lepromatous leprosy

Gelber RH, Waters MF, Pearson JM, Rees RJ, McDougall AC

Lepr Rev, 1977 Dec;48(4):223-9.

PMID: 400806

Matched MeSH terms: Mycobacterium leprae/drug effects

Fulltext Leprosy in Malaysia

Jayalakshmi P

Malays J Pathol, 1994 Jun;16(1):7-9.

PMID: 16329568

Leprosy is a chronic infectious disease and is still a public health problem in Malaysia. In 1926, the Leper Enactment Act was established which required compulsory notification and isolation of leprosy patients. As a result, the National Leprosy Control Centre (NLCC) was built in Sungai Buloh, Selangor. In 1969, the National Leprosy Control programme was launched with the objective of early case finding and decentralisation of treatment of leprosy. The treatment of leprosy patients is integrated with basic Medical and Health services in Malaysia. With the implementation of multiple drug therapy in 1985, the National prevalence rate of leprosy has reduced from 5.7 per 10,000 in 1983 to 1.7 per 10,000 in 1992. The Research Unit in NLCC was established in 1950, where cultivation of Mycobacterium leprae using mouse foot-pad technique is done. This technique is used for assessment of efficacy of chemotherapeutic agents in leprosy. Research activites are also done in collaboration with the Institute for Medical Research in Kuala Lumpur such as isolation of Mycobacterium leprae antigen using T cell clones and phenolic glycolipid antigen.

Matched MeSH terms: Mycobacterium leprae/drug effects; Mycobacterium leprae/growth & development

Naturally acquired leprosy-like disease in the nine-banded armadillo (Dasypus novemcinctus): reactions in leprosy patients to lepromins prepared from naturally infected armadillos

Meyers WM, Walsh GP, Brown HL, Rees RJ, Convit J

J Reticuloendothel Soc, 1977 Oct;22(4):369-75.

PMID: 336883

Matched MeSH terms: Mycobacterium leprae

Sulphone resistance in leprosy. A review of one hundred proven clinical cases

Pearson JM, Rees RJ, Waters MF

Lancet, 1975 Jul 12;2(7924):69-72.

PMID: 49662

An account is given of the first hundred consecutive proven cases of sulphone resistance in leprosy, detected in Malaysia between 1963 and 1974. Proof of resistance was clinical in eighty patients and was obtained by drug-sensitivity testing in mice in ninety-six patients; 76 cases were proved both clinically and experimentally, and there was no discrepancy between the two methods. Sulphone resistance was confined to patients with lepromatous-type leprosy--i.e., patients with a large bacterial population. Clinical evidence of relapse due to drug resistance appeared 5-24 years after the start of sulphone treatment. Low dosage favoured the appearance of resistance; therefore regular treatment of lepromatous leprosy with dapsone in full dosage is recommended. The attainment of "skin smears negative for leprosy bacilli" is no test of cure of lepromatous leprosy.

Matched MeSH terms: Mycobacterium leprae/drug effects*

Fulltext Studies on sulfone resistance in leprosy. 3. A case of "partial" resistance

Pearson JMH, Pettit JHS, Rees RJ

Int. J. Lepr. Other Mycobact. Dis., 1968;36(2):171-8.

PMID: 4877115

Proof that a patient is suffering from sulfone-resistant leprosy depends on demonstrating that his bacilli can multiply in the mouse foot pad even when the mice are fed sulfone in the diet. Hitherto the maximal dose of DDS tolerated by the mouse has been used in such tests. This paper concerns a patient whose bacilli multiplied in mice fed lower doses of DDS, but were inhibited when the maximal dose was used . His clinical features are distinctive and probably characteristic of this type of "partial" resistance. It is likely that more cases of this type will be found . Recommendations are made concerning the investigation of possible DDS-resistant leprosy patients and their treatment.

Matched MeSH terms: Mycobacterium leprae/drug effects*

Fulltext Analysis of the leprosy agents Mycobacterium leprae and Mycobacterium lepromatosis in four countries

Han XY, Aung FM, Choon SE, Werner B

Am J Clin Pathol, 2014 Oct;142(4):524-32.

PMID: 25239420 DOI: 10.1309/AJCP1GLCBE5CDZRM

To differentiate the leprosy agents Mycobacterium leprae and Mycobacterium lepromatosis and correlate them with geographic distribution and clinicopathologic features.

Matched MeSH terms: Mycobacterium leprae/isolation & purification*

Leprae reaction resembling rheumatologic disease as presenting feature of leprosy

Baharuddin H, Taib T, Zain MM, Ch'ng S

Int J Rheum Dis, 2016 Oct;19(10):1035-1038.

PMID: 27456320 DOI: 10.1111/1756-185X.12916

Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae with predominant involvement of skin and nerves. We present a 70-year-old man with leprosy whose initial presentation resembled rheumatologic disease, due to leprae reaction. He presented with an 8-week history of worsening neuropathic pain in the right forearm, associated with necrotic skin lesions on his fingers that had ulcerated. Physical examination revealed two tender necrotic ulcers at the tip of the right middle finger and the dorsal aspect of the left middle finger. The patient had right wrist tenosynovitis and right elbow bursitis. Apart from raised inflammatory markers, the investigations for infection, connective tissue disease, vasculitis, thromboembolic disease and malignancy were negative. During the fourth week of hospitalization, we noticed a 2-cm hypoesthetic indurated plaque on the right inner arm. Further examination revealed thickened bilateral ulnar, radial and popliteal nerves. A slit skin smear was negative. Two skin biopsies and a biopsy of the olecranon bursa revealed granulomatous inflammation. He was diagnosed with paucibacillary leprosy with neuritis. He responded well to multidrug therapy and prednisolone; his symptoms resolved over a few weeks. This case illustrates the challenges in diagnosing a case of leprosy with atypical presentation in a non-endemic country.

Matched MeSH terms: Mycobacterium leprae/isolation & purification*

Fulltext Primary dapsone resistant Mycobacterium leprae in a non endemic country

Jamil A, Noor NM, Osman AS, Baseri MM, Muthupalaniappen L

Indian J Dermatol Venereol Leprol, 2013 Jul-Aug;79(4):527-9.

PMID: 23760326 DOI: 10.4103/0378-6323.113096

Matched MeSH terms: Mycobacterium leprae/drug effects*

Orbital apex syndrome due to trigeminal perineural spread of sinonasal leprosy: a case report

El Beltagi AH, El-Nil H, Alrabiah L, El Shammari N

Clin Imaging, 2012 Mar-Apr;36(2):142-5.

PMID: 22370135 DOI: 10.1016/j.clinimag.2011.07.004

Leprosy is a granulomatous disease primarily affecting the skin and peripheral nerves caused by Mycobacterium leprae, but also significantly involving sinonasal cavities and cranial nerves. It continues to be a significant public health problem, and despite multidrug therapy, it can still cause significant morbidity. The awareness of cranial nerve, intracranial and orbital apex involvement as in our case is important for appropriate treatment measures.

Matched MeSH terms: Mycobacterium leprae/isolation & purification

Fulltext Isolated Bilateral Pinna Swelling: A Rare Initial Presentation of Leprosy

Yusuf SYM, Ismail IA, Hamid RA, Jamil NA, Yasin MM

Open Access Maced J Med Sci, 2019 Jun 15;7(11):1815-1817.

PMID: 31316665 DOI: 10.3889/oamjms.2019.481

BACKGROUND: Leprosy or Hansen disease is a chronic infectious disease that causes social stigma due to its deforming bodily appearance and physical disability. It has a wide spectrum of presentation affecting diagnosis.

CASE REPORT: A 21-year-old man who presented with chronic isolated bilateral pinna swelling as a result of leprosy is reported. The bilateral pinna swelling started as multiple shiny papules with an erythematous background and progressively became hyperpigmented and lobular over two years. This rare presentation of leprosy poses initial diagnostic difficulties, leading to misdiagnoses by various health care professionals. Diagnoses ascribed include eczema, insect bite and perichondritis. A suspicion of leprosy was raised when hyperaesthetic hypopigmentation of skin started to appear on the body after two years, with worsening of the pinna swellings. This was confirmed by identification of Mycobacterium leprae in slit skin smear test and skin biopsy.

CONCLUSION: Isolated involvement of pinna in a patient without lesions in other body parts is an unusual initial presentation of leprosy. However, leprosy should be kept as a rare differential diagnosis of isolated lesions on the ear in patients not responding to conventional treatment.

Matched MeSH terms: Mycobacterium leprae

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