Oral lesions in leprosy revisited: a case report.

There is a scarcity of the histopathologically proven lesions of leprosy in the oral cavity, in the world literature. A 55-year-old man had come with a complaint of asymptomatic nodular lesions in the oral cavity. Cutaneous lesions and peripheral nerve examination were suggestive of lepromatous leprosy. Histopathologic examination of a nodule on the palate demonstrated diffuse macrophagic granulomas and acid-fast bacilli.

[Protease activity of microflora in the oral cavity of patients with periodontitis].

Microbial spectrum and non-specific as well as specific IgA1 protease activity of isolated microorganisms were investigated in gingival liquid of patients with periodontitis. Microorganisms from the gingival liqud of these patients belonged to conditional-pathogenic obligate and facultatively anaerobic bacteria. 24 strains of microorganisms have been identified. Nonspecific proteolytic activity was found in the following microorganisms: Actinomyces israelii, Actinomyces naeslundii, Aerococcus viridans, Bifidobacterium longum, Neisseria subflave, Streptococcus parvulus, Eubacterium alactolyticum, Lactobaccilus catenoforme, Bacillus spp. Specific IgA1-protease activity and lack of proteolytic activity towards IgG was found in Streptococcus acidominimus, Streptococcus hansenii, Streptococcus salivarius, Leptotrychia buccalis, Staphylococcus haemolyticus and Neisseria sicca. No proteolytic activity was found in cultivation medium of Eubacterium alactolyticum (1 strain), Prevotella buccalis, Aerococcus viridans and Streptococcus sanguis.

Considerações sobre o envolvimento da cavidade bucal na hanseníase / Considerations on oral cavity involvement in leprosy

As lesões causadas pela proliferação do Mycobacterium leprae (M. leprae) foram significantemente reduzidas nos últimos anos com a detecção precoce de casos novos.Consequentemente, as lesões maxilofaciais e da mucosa bucal passaram ser cada vez menos relatadas. A despeito de ser menos evidente, a infecção da cavidade bucal pelo M. leprae pode revelar detalhes importantes a respeito da transmissibilidade e imunopatogenia da hanseníase.A associação entre a infecção da mucosa bucal e a perda óssea alveolar, bem como a participação da resposta imune local na proteção contra a doença, ainda são tópicos de pesquisa não explorados totalmente. Infelizmente, o tratamento da hanseníase não possibilitou a prevenção total de suas seqüelas, nem impediu transmissão dessa doença. As razões acima justificam rever algumas perguntas não respondidas do passado.

Lesions secondary to Mycobacterium leprae (M. leprae) proliferation have been significantly abbreviated in recent years due to early detection of new cases of leprosy. Consequently, oral and maxillofacial lesions have been each time less reported. In spite of been less evident, the infection of oral cavity by M. leprae may reveal important details regarding the transmission and immunopathology of leprosy. The association between oral mucosal infection and alveolar bone loss, as well as the role of local immune response in protection against this pathogen, are still not fully explored. Unfortunately, the treatment of leprosy did not allow the full prevention of sequels neither hindered the transmission of this disease. The reasons above justify reviewing some unanswered questions of the past.

First report of oral colonization by Debaryomyces nepalensis in a dog.

A stray, young male, wire-haired pointing griffon dog, found in a street of Perugia (Italy), was examined in order to check his health status. Two oropharyngeal swabs were collected in 24 h and streaked onto Sabouraud agar and after 6 days the yeasts colonies were transferred onto Malt agar. Ascospores were observed on Potato Dextrose Agar medium. The major ubiquinone of an isolated yeast was identified as ubiquinone-9 (Q-9), and genetical analyses were performed together with the type strains of Debaryomyces hansenii (var. hansenii and var. fabry), C. psychrophila and D. nepalensis type strain. The base sequences of ITS1 and ITS2, and D1/D2 domains of LSU rDNA completely coincided with those of D. nepalensis. From these results, the isolated yeast was identified as D. nepalensis. RAPD patterns between the two strains were found to be identical. The results indicate the first colonization of D. nepalensis in a dog.

High oral prevalence of Candida krusei in leprosy patients in northern Thailand

Although Candida albicans is the most common human yeast pathogen, other Candida species such as C. krusei are now recognized as emerging agents, especially in patients with human immunodeficiency virus (HIV) disease. C. krusei is inherently resistant to the widely used triazole antifungal fluconazole and poses therapeutic problems, especially in systemic candidiasis. In a surveillance study of leprosy patients (with arrested or burnt-out disease) in a leprosarium in northern Thailand, we found a rate of oral carriage of C. krusei (36 per cent) significantly (P smaller 0.05) higher than that for a healthy control group (10 per cent). Among the Candida-positive patients, 16 of 35 (46 per cent) carried C. krusei, while C. albicans was the second most common isolate (12 of 35 patients; 34 per cent). The corresponding figures for the control group were 2 of 13 (15 per cent) and 6 of 13 (46 per cent), respectively. Studies of the antifungal resistance of the C. krusei isolates from patients indicated that all except one of the isolates were resistant to fluconazole, two isolates were resistant to ketoconazole, and all isolates were sensitive to amphotericin B. Evaluation of their genetic profiles by randomly amplified polymorphic DNA analysis with three different primers and subsequent analysis of the gel profiles by computerized cluster-derived dendrograms revealed that the C. krusei isolates from patients belonged to 10 disparate clusters, despite the origin from a single locale. These nascent findings indicate an alarmingly high prevalence of a Candida species resistant to a widely used antifungal in a part of the world where HIV disease is endemic.

Persistence and distribution of Mycobacterium leprae in Aedes aegypti and Culex fatigans experimentally fed on leprosy patients.

Laboratory reared Aedes aegypti and Culex fatigans were experimentally fed on untreated lepromatous leprosy patients and the proboscides, guts and faeces of the mosquitoes were examiend at 12 hour intervals to determine the persistence and distribution of Mycobacterium leprae. In A. aegypti, bacilli persisted in proboscis till 156 hours, in gut 96 hours, and in faeces 72 hours after feeding. In C. fatigans--proboscides 144 hours, gut 96 hours and faeces 72 hours after feeding. In A. aegypti solid bacilli were present in proboscis upto 96 hours; in gut 48 hours and in faeces 42 hours after feeding. Corresponding figures for C. fatigans were: 144 hours for proboscis, 48 hours for gut, solid bacilli being absent in faeces. The results are discussed from the point of view of arthropod transmission.