RESUMEN
As identified by a significant growth in the footpads of immunosuppressed mice, the incidence of viable bacteria in a group of 26 multibacillary (BL-LL) patients released from multidrug (MDT) treatment was found to be two times more in the nerves (46%) as compared to skin (23%). Evidently there was a positive correlation between the overall bacterial load and the incidence of viable organisms. Bacterial growth was also observed in two out of five cases where neither the skin nor the nerve homogenate had shown any presence of acid-fast bacilli. Histopathology of biopsies, skin as well as nerve, including those having viable bacteria did not show any features of active disease.
Asunto(s)
Leprostáticos/administración & dosificación , Lepra/tratamiento farmacológico , Lepra/microbiología , Mycobacterium leprae/aislamiento & purificación , Nervios Periféricos/microbiología , Piel/microbiología , Adolescente , Adulto , Animales , Biopsia con Aguja , Recuento de Colonia Microbiana , Esquema de Medicación , Quimioterapia Combinada , Femenino , Humanos , Lepra/patología , Masculino , Ratones , Persona de Mediana Edad , Mycobacterium leprae/efectos de los fármacos , Nervios Periféricos/efectos de los fármacos , Nervios Periféricos/patología , Pronóstico , Piel/efectos de los fármacos , Piel/patologíaRESUMEN
Skin and nerve biopsies obtained from 18 multibacillary (MB) and 16 paucibacillary (PB) cases of leprosy who had been fully treated by the WHO regimen were assessed for bacterial load using different staining techniques. In addition skin and nerve homogenates of 10 MB cases were tested for 'persistor' Mycobacterium leprae using immunosuppressed mice. While significant amounts of integral bacilli and BCG cross-reactive antigen of M. leprae were detected both in skin and nerve tissues of all the MB cases (100%), 56% of skin and 62% of nerve biopsies of PB cases also showed the presence of BCG cross-reactive antigen. Detection of 'persistor' M. leprae in 2/10 skin biopsies (20%) and 3/10 nerve biopsies (30%) of MB cases was thought to be unexpectedly high after 2 years of MDT.