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BACTERIAL INFECTIONS-LEPROSY (Medical Management (Dapsone (Aczone) 2mg/kg,…
BACTERIAL INFECTIONS-LEPROSY
Definition
Leprosy is a chronic, progressive bacterial infection caused by the bacterium Mycobacterium leprae. It primarily affects the nerves of the extremities, the skin, the lining of the nose, and the upper respiratory tract. Leprosy is also known as Hansen’s disease.
Signs and Symptoms
Muscle weakness
Numbness in the hands, arms, feet, and legs
Skin lesions
Classification
In tuberculoid leprosy, the immune response is good.
A person with this type of infection only exhibits a few lesions. The disease is mild and only mildly contagious.
In lepromatous leprosy, the immune response is poor
. This type also affects the skin, nerves, and other organs. There are widespread lesions, including nodules (large lumps and bumps). This form of disease is more contagious.
In borderline leprosy, there are clinical features of both tuberculoid and lepromatous leprosy
. This type is considered to be between the other two types.
Diagnostic Procedure
Physical Exam
Biopsy
Lepromin skin test
Medical Management
Dapsone (Aczone) 2mg/kg
Rifampin (Rifadin) 600mg
Clofazimine (Lamprene) 300mg
Minocycline (Minocin) 100mg
Ofloxacin (Ocuflux) 400mg
Complications
Disfigurement
Hair loss, particularly on the eyebrows and eyelashes
Muscle weakness
Permanent nerve damage in the arms and legs
Surgical Management
The goals of surgical treatment in patients with leprosy are to prevent further deterioration, to improve motor function, and, in some cases, to improve sensation.
Nerve Grafting
Neural Surgery
Amputation
Pathophysiology
Leprosy can manifest in different forms, depending on the host response to the organism.
Individuals who have a vigorous cellular immune response to M leprae have the tuberculoid form of the disease that usually involves the skin and peripheral nerves. The number of skin lesions is limited, and they tend to be dry and hypoesthetic. Nerve involvement is usually asymmetric. This form of the disease is also referred to as paucibacillary leprosy because of the low number of bacteria in the skin lesions (ie, < 5 skin lesions, with absence of organisms on smear). Results of skin tests with antigen from killed organisms are positive in these individuals.
Nursing Management
Detect the disease in the initial stages and watch over other susceptible patients
Take care of localized wound
Rehabilitate cured persons
Provide health education
Provide follow up service
Causes
Mycobacterium leprae and Mycobacterium lepromatosis are the causative agents of leprosy. Mycobacterium can spread from person to person. This might happen when someone with the disease coughs or sneezes. This can release droplets into the air. It might also happen if somebody is exposed to other nasal fluids (also known as secretions) that might be contaminated with the bacteria.
Risk Factors
Inadequate bedding
Contaminated water
Insufficient diet, or other diseases that compromise immune function
Nursing Care Plan
Nursing Interventions
Diagnose the impaired tissue integrity and monitor the characteristics of the lesion such as size, color, odor and drainage.
Clean the wounds with saline or nontoxic substances as indicated.
Compare the changes of ulcer daily and record regularly.
Monitor any sings of adverse effects regarding medications and take proper action.
Protect hands and feet to avoid inadvertent injury and prevent chronic disability.
Educate the patient and family members about importance of continuing treatment with Multidrug therapy (MDT) and evaluate the efficacy of Multidrug therapy (MDT).
Provide knowledge and increase awareness about advance sings of neuropathy.