Mycobacterium leprae infection

PABA) incorporation into folic acid (inhibition of folate synthesis). In large proportion of Mycobacterium leprae infections e.g. in lepromatous leprosy, resistance can develop, so combination of dapsone, rifampicin and clofazimine is used in initial therapy. 

Klebanoff SJ and Shepard CC Toxic Effect of the Peroxidase-hydrogen peroxide-halide Antimicrobial System on Mycobacterium leprae. Infect. Immun. 1984 44(2) 534-6. 

Assehneau, C. Clavel, S. Clement,F. Daffe, M. David, H. Laneelle, M. A. Prome, J. C. Lipid constituents of Mycobacterium leprae isolated from experimentally infected armadillo. Anna . Microbiol. (Paris) 1981,132A, 19-30. 

The lepromatous form of leprosy is characterized by loss ofcutaneoussensibility. Hansen sbacillus(Mycobacterium leprae), which proliferates only in environments cooler than the core temperature maintained by most mammals, is capable of infecting Schwann cells in subcutaneous nerves because the basal lamina of these cells contains a-dystroglycan, to which this mycobacterium binds, and because subcutaneous nerves are often cooler than deeper tissues. Lepromatous neuropathy is a common cause of sensory mononeuropathy multiplex in the developing World [16,17]. 

Not all mycobacterial infections are caused by Mycobacterium tuberculosis or Mycobacterium leprae. These atypical mycobacteria require treatment with secondary medications as well as other chemotherapeutic agents. For example, Mycobacterium marinum causes skin granulomas, and effective drugs in the treatment of the infection are rifampin or minocycline. Mycobacterium fortuitum causes skin ulcers, and the medications recommended for treatment are ethambutol, cycloserine, and rifampin in combination with amikacin. 

Clarithromycin or azithromycin is recommended as first-line therapy for prophylaxis and treatment of disseminated infection caused by M. avium-intracellulare in AIDS patients and for treatment of pulmonary disease in non-HIV-infected patients. Azithromycin (1.2 g once weekly) or clarithromycin (500 mg twice daily) is recommended for primary prevention for AIDS patients with fewer than 50 CD cells per mm. Single-agent therapy should not be used for treatment of active disease or for secondary prevention in AIDS patients. Clarithromycin (500 mg twice daily) plus ethambutol (15 mg/kg once daily) with or without rifabutin is an effective combination regimen. Azithromycin (500 mg once daily) may be used instead of clarithromycin, but clarithromycin appears to be slightly more efficacious. Clarithromycin also has been used with minocychne for the treatment of Mycobacterium leprae in lepromatous leprosy. 

Fragment of Mycobacterium leprae phenolic glycolipids responsible for their immunological specificity. Has been used in experimental serological tests for leprosy infection in humans. Phenylosazone ... 

First drug injection was 400 mg/k given 58 days after infection with Mycobacterium leprae] subsequent injections were 200 mg/kg at intervals of 0.5, 1, or 2 months. 

Leprosy A 58-year-old man with ankylosing spondylitis, receiving infliximab, developed multiple plaques on the face, chest, and limbs, a thickened, tender ulnar nerve, and severe neuritis of the feet biopsy showed lepromatous Hansen s disease [133 ]. In this case the use of infliximab may have resulted in either a new infection or reactivation of a latent infection with Mycobacterium leprae. 

PORTAELS, F., M. Daffe, M.A. Laneelle, and C. Asselineau Etude de la composition lipidique de mycobacteries isolees de foies de tatous infectes par Mycobacterium leprae. Ann. Microbiol. (Inst. Pasteur) 135 A, 457 (1984). 

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