II-A. Systemic Bacteriology | 15. Atypical mycobacteria, Mycobacterium leprae

Question 1

I. Atypical Mycobacteria
1. What are the features of Atypical Mycobacteria?

Answer 1

• Facultative pathogens or pathogens
• disease= “mycobacteriosis”
• NTM= nontuberculous mycobacteria
• slow growing species
• rapidly growing species

Question 2

I. Atypical Mycobacteria
2. What are examples of Non-TB mycobacteria?

Answer 2

M. avium, M. intracellulare, M. kansasi, M. marinum, M. ulcerans

Question 3

I. Atypical Mycobacteria
3. Feature of M. marinum?

Answer 3

skin lesions (can be acquired in pools)

Question 4

I. Atypical Mycobacteria
4. Feature of M. ulcerans?

Answer 4

subcutaneous nodules, Buruli-ulcer

Question 5

I. Atypical Mycobacteria
5. Feature of MAC (mycobacterium avian complex)

Answer 5

MAC: sever infections of immunosuppressed patitens
- even TB-like disease could develop!

Question 6

II. Mycobacterium leprae
1. What are the features of Mycobacterium leprae?

Answer 6

proliferates inside of endothelial cells, Schwann-cells
- long incubation period (years!)

Question 7

II. Mycobacterium leprae
2. What is the source of infection of Mycobacterium leprae?

Answer 7

infected person (or extremely rarely: armadillos)

Question 8

II. Mycobacterium leprae
3. What are the diseases caused by Mycobacterium leprae?

Answer 8

leprosy (Hansen’s disease)

Question 9

II. Mycobacterium leprae - leprosy (Hansen’s disease)
4. What are the 2 main types of leprosy (Hansen’s disease)?

Answer 9

1. tuberculoid leprosy
2. lepromatous leprosy

Question 10

II. Mycobacterium leprae - leprosy (Hansen’s disease)
5. What are the features of tuberculoid leprosy?

Answer 10

1. proper immunreaction against the pathogen
   - Th1 mediated (cellular immunreaction)
2. granulomas
3. neuropathy

Question 11

II. Mycobacterium leprae - leprosy (Hansen’s disease)
6. What are the features of lepromatous leprosy?

Answer 11

1. weak / improper immunreaction
   - Th2 mediated (humoral immunreaction)
2. bone- and skin lesions
   - spontaneous amputations!
3. weak prognosis

Question 12

II. Mycobacterium leprae - leprosy (Hansen’s disease)
7. How do we diagnose leprosy (Hansen’s disease)

Answer 12

• based on clinical sign and symptoms
• sampling: biopsy
• laboratory: microscopy, PCR

Question 13

II. Mycobacterium leprae - leprosy (Hansen’s disease)
8. How do we treat Mycobacterium leprae?

Answer 13

• rifampicin + dapson (6 months long)
• • clofazimin for 1 year in lepromatous form

Question 14

II. Mycobacterium leprae - leprosy (Hansen’s disease)
9. Make a comparison between tuberculoid leprosy and lepromatous leprosy

Answer 14