scholarly journals High relapse rate among lepromatous leprosy patients treated with rifampin plus ofloxacin daily for 4 weeks.

1997 ◽  
Vol 41 (9) ◽  
pp. 1953-1956 ◽  
Author(s):  
B Ji ◽  
P Jamet ◽  
S Sow ◽  
E G Perani ◽  
I Traore ◽  
...  
Keyword(s):  
Relapse Rate ◽  
Great Majority ◽  
Mycobacterium Leprae ◽  
Lepromatous Leprosy ◽  
Multiple Resistance ◽  
Confidence Limits ◽  
Multidrug Therapy ◽  
High Relapse Rate ◽  
Leprosy Patients

Fifty-one lepromatous leprosy patients, all of whom had relapsed after previous dapsone (DDS) monotherapy, were treated between 1990 and 1991 with 600 mg of rifampin (RMP) plus 400 mg of ofloxacin (OFLO) daily for 4 weeks, and the great majority of the patients were followed up at least once a year after completion of the treatment. After only 173 patient-years of follow-up, 5 relapses had been detected; the overall relapse rate was 10.0% (confidence limits, 1.7 and 18.3%), or 2.9 relapses (confidence limits, 0.4 and 5.4) per 100 patient-years. The unacceptably high relapse rate indicated that 4 weeks of treatment with daily RMP-OFLO was unable to reduce the number of viable Mycobacterium leprae organisms to a negligible level. In addition, the M. leprae from one of the relapses were proved to have multiple resistance to DDS, RMP, and OFLO. To avoid further relapses, the follow-up was terminated and the great majority of the patients were retreated with the standard 2-year multidrug therapy from 1994. No further relapse has been diagnosed since the beginning of retreatment.

scholarly journals Lsr2 Peptides of Mycobacterium leprae Show Hierarchical Responses in Lymphoproliferative Assays, with Selective Recognition by Patients with Anergic Lepromatous Leprosy

2011 ◽  
Vol 80 (2) ◽  
pp. 742-752 ◽  
Author(s):  
Mehervani Chaduvula ◽  
A. Murtaza ◽  
Namita Misra ◽  
N. P. Shankar Narayan ◽  
V. Ramesh ◽  
...  
Keyword(s):  
T Cell ◽  
T Cell Responses ◽  
Mycobacterium Leprae ◽  
Lepromatous Leprosy ◽  
Healthy Controls ◽  
Content Type ◽  
Tuberculosis Patients ◽  
Cell Responses ◽  
Leprosy Patients

ABSTRACTLsr2 protein ofMycobacterium lepraewas shown earlier to elicit B and T cell responses in leprosy patients (20, 28). Lymphoproliferation toM. lepraeand Lsr2 antigens was observed in >70% of tuberculoid (T) patients and in 16 and 34% of lepromatous (L) patients, respectively. We focused on theM. lepraenonresponders in the lepromatous group using 22 synthetic Lsr2 peptides (end-to-end peptides A to F and overlapping peptides p1 to p16) inin vitroT cell responses. A total of 125 leprosy and 13 tuberculosis patients and 19 healthy controls from the area of endemicity (here, healthy controls, or HC) were investigated. The highest responses were observed (67 to 100%) in HC for all peptides except p1 to p3, and the lowest was observed in tuberculosis patients. Significant differences in lymphoproliferation were observed in T, L, and HC groups (analysis of variance [ANOVA],P= 0.000 to 0.015) for all end-to-end peptides except B and for p5 and p7 to p10. Hierarchical recognition between lepromatous and tuberculoid leprosy was noted for p8 (P< 0.05) and between the HC and L groups for p7 to p10, p15, and p16 (P< 0.005 toP< 0.02). Significant lymphoproliferation was observed to peptides A to F and p1 to p9, p11, p12, p15, p16 (P= 0.000 to 0.001) with 40% responding to peptides C and p16 in L patients. Lepromatous patients also showed significantly higher levels of a gamma interferon (IFN-γ) response to peptide C than to other peptides (P< 0.05). Major histocompatibility complex (MHC) class II bias for peptide recognition was not observed. These studies indicate that Lsr2 has multiple T cell epitopes that inducein vitroT cell responses in the highly infective lepromatous leprosy patients.

scholarly journals Lepromatous leprosy masquerading as rhinophyma

2015 ◽  
Vol 1 (1) ◽  
pp. 34
Author(s):  
Sowmyashree Krishna ◽  
Malcolm Pinto ◽  
Manjunath Mala Shenoy ◽  
Mahesh SG
Keyword(s):  
Infectious Disease ◽  
Global Health ◽  
Health Problem ◽  
Mycobacterium Leprae ◽  
Lepromatous Leprosy ◽  
The Body ◽  
Multidrug Therapy ◽  
Diagnostic Challenge ◽  
Cervical Lymphadenitis ◽  
Global Health Problem

<p>Leprosy a major global health problem, especially in the developing world, is an infectious disease caused by <em>Mycobacterium leprae</em>. Leprosy has a predilection to with cooler areas of the body. Lepromatous leprosy presents with varied manifestations like nodules, cervical lymphadenitis, hyperpigmented patches and other presentations which can mimic various other diseases and pose a diagnostic challenge in endemic areas. We report a case presenting with nodular infiltration of the nose mimicking rhinophyma who presented with faint reddish swelling over the nose which progressed to nodular infiltration. There was bilateral symmetrical thickening of nerves following which diagnosis was confirmed by slit skin smear and the patient was started on multibacillary multidrug therapy. The importance of rightly diagnosing cases presenting as nodules that mimic rhinophyma is important because of the infectious nature of the disease which pose a threat to the community.</p>

Self-Administered Drug Compliance in Nepali Leprosy Patients

1989 ◽  
Vol 19 (2) ◽  
pp. 59-61
Author(s):  
P W Roche ◽  
S Failbus ◽  
W Britton
Keyword(s):  
Colorimetric Assay ◽  
Relative Sensitivity ◽  
Spot Test ◽  
The Self ◽  
Multidrug Therapy ◽  
Drug Compliance ◽  
Self Administration ◽  
Leprosy Patients ◽  
Length Of Therapy

The self administration of dapsone by Nepali leprosy patients receiving multidrug therapy was assessed by a colorimetric and a filter paper spot test. Overall 45 out of 337 (13.3%) patients were found to be non-compliant. The relation of non-compliance to sex, age, leprosy classification, therapy type and length of therapy was investigated. The spot test was compared with the colorimetric assay and found to have a relative sensitivity of 99.3% and specificity of 95.4%. Follow up of patients was successful in that two-thirds of non-compliant patients were compliant on their follow-up test.

scholarly journals Detection of Mycobacterium leprae DNA for 36kDa protein in urine from leprosy patients: a preliminary report

2004 ◽  
Vol 46 (5) ◽  
pp. 275-277 ◽  
Author(s):  
Om Parkash ◽  
Hari Bhan Singh ◽  
Subha Rai ◽  
Archna Pandey ◽  
Vishwa Mohan Katoch ◽  
...  
Keyword(s):  
Treatment Response ◽  
Preliminary Report ◽  
Mycobacterium Leprae ◽  
Lepromatous Leprosy ◽  
Healthy Individuals ◽  
Specific Pcr ◽  
Number Of Patients ◽  
Tuberculoid Leprosy ◽  
Leprosy Patients ◽  
First Time

We have searched for Mycobacterium leprae DNA for 36kDa protein in urine using a M. leprae specific PCR technique. A limited number of 16 patients (of which 11 belonged to lepromatous leprosy and five to tuberculoid leprosy) and eight healthy individuals were included for the present study. The number of urine samples positive by PCR were 36.4% (4/11) in lepromatous patients and 40% (2/5) in tuberculoid patients. None of the samples from healthy individuals was positive. To our knowledge, the results indicate, for the first time, the presence of M. leprae DNA in urine from leprosy patients. Another important finding obtained out of the study is that amongst treated patients 66.6% (4/6) were positive whereas amongst untreated only 20% (2/10) were positive. From the present indicative data it appears that treatment improves the PCR results with urine as a sample. Thus, the approach could prove to be useful for monitoring the treatment response of individual patients and needs to be further evaluated with a large number of patients.

scholarly journals Giant cells lepromatous leprosy. Diffuse dermatitis with exuberant foreign body giant cells in treated lepromatous leprosy

Biomédica ◽  
2019 ◽  
Vol 39 (Supl. 2) ◽  
pp. 26-31
Author(s):  
Gerzaín Rodríguez ◽  
Viviana Arias
Keyword(s):  
Foreign Body ◽  
Giant Cells ◽  
Skin Lesions ◽  
Lepromatous Leprosy ◽  
World Health ◽  
Multidrug Therapy ◽  
Foreign Body Giant Cells ◽  
Health Organization

Patients with lepromatous leprosy that have received treatment for many years usually get follow up biopsies for persistent skin lesions or positive bacilloscopy even if the values are lower than in the initial bacilloscopy.We report the case of a 48-year old woman with long-standing lepromatous leprosy of 15 years of evolution, with a bacterial index of 4 in the direct smear and the initial skin biopsy.The patient was treated with multidrug therapy for 32 months although the treatment recommended by the World Health Organization (WHO) is only for 12 months.A skin biopsy was taken to determine if there was an active disease. We observed a diffuse dermal inflammation with numerous foreign body giant cells and vacuolated macrophages (Virchow´s cells). These cells contained granular acid-fast material that was also positive with immunohistochemistry for BCG. There were fragmented bacilli and the BI was 2.These cells were also strongly positive for CD68. The biopsy was interpreted as a residual form of lepromatous leprosy that did not require further multidrug therapy.We have observed similar histological profiles in several cases. The lack of clinical data makes it a histological challenge. The accumulation of lipids in these giant cells is due to bacillary destruction and fusion of vacuolated macrophages. We discuss here the role of bacillary and host lipids in the pathogenesis of lepromatous leprosy. We concluded that there was no need to extend the 12-month multidrug therapy recommended by WHO.

Bactericidal activity of single dose of clarithromycin plus minocycline, with or without ofloxacin, against Mycobacterium leprae in patients.

1996 ◽  
Vol 40 (9) ◽  
pp. 2137-2141 ◽  
Author(s):  
B Ji ◽  
P Jamet ◽  
E G Perani ◽  
S Sow ◽  
C Lienhardt ◽  
...  
Keyword(s):  
Single Dose ◽  
Bactericidal Activity ◽  
Great Majority ◽  
Mycobacterium Leprae ◽  
Bactericidal Effect ◽  
Lepromatous Leprosy ◽  
Standard Regimen ◽  
Before And After ◽  
Group A ◽  
Gastrointestinal Adverse Events

Fifty patients with newly diagnosed lepromatous leprosy were allocated randomly to one of five groups and treated with either a month-long standard regimen of multidrug therapy (MDT) for multibacillary leprosy, a single dose of 600 mg of rifampin, a month-long regimen with the dapsone (DDS) and clofazimine (CLO) components of the standard MDT, or a single dose of 2,000 mg of clarithromycin (CLARI) plus 200 mg of minocycline (MINO), with or without the addition of 800 mg of ofloxacin (OFLO). At the end of 1 month, clinical improvement accompanied by significant decreases of morphological indexes in skin smears was observed in about half of the patients of each group. A significant bactericidal effect was demonstrated in the great majority of patients in all five groups by inoculating the footpads of mice with organisms recovered from biopsy samples obtained before and after treatment. Rifampin proved to be a bactericidal drug against Mycobacterium leprae more potent than any combination of the other drugs. A single dose of CLARI-MINO, with or without OFLO, displayed a degree of bactericidal activity similar to that of a regimen daily of doses of DDS-CLO for 1 month, suggesting that it may be possible to replace the DDS and CLO components of the MDT with a monthly dose of CLARI-MINO, with or without OFLO. However, gastrointestinal adverse events were quite frequent among patients treated with CLARI-MINO, with or without OFLO, and may be attributed to the higher dosage of CLARI or MINO or to the combination of CLARI-MINO plus OFLO. In future trials, therefore, we propose to reduce the dosages of the drugs to 1,000 mg of CLARI, 100 mg of MINO, and 400 mg of OFLO.

scholarly journals Grade 2 disabilities in leprosy patients from Brazil: Need for follow-up after completion of multidrug therapy

2018 ◽  
Vol 12 (7) ◽  
pp. e0006645 ◽  
Author(s):  
Marcos Túlio Raposo ◽  
Martha Cerqueira Reis ◽  
Ana Virgínia de Queiroz Caminha ◽  
Jörg Heukelbach ◽  
Lucy Anne Parker ◽  
...  
Keyword(s):  
Multidrug Therapy ◽  
Leprosy Patients
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