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Chapter 20 Lecture 2 (Hansen’s Disease (Leprosy) (Pathogenesis- grows…

- - - - Nonprogressive form of the disease due to pts with a strong T cell immune response
      - Strong cell-mediated immune response
      - Regions of skin have lost sensation as a result of nerve damage
    - - More virulent form of the disease
      - Weak cell-mediated immune response
      - Bacteria multiplies in skin and mucous membranes and nerve cells
      - Destroys tissues and leads to progressive loss of facial features, digits and other body structures
      - s/s come on slowly and could take years to come out
  - - - Gram-positive bacillus with a cell wall that contains Mycolic acid which is responsible for several characteristics of the bacterium:
        
        Slow growth rate
        
        Protection from phagocytic lysis
        
        Growth within phagocytes
        
        Resistance to many antimicrobial drugs
  - - - May destroy nerves and other tissues
  - - - 1990s 12 million cases were dx
      - 2015- 210,000 including 64 cases in US
  - - - A loss of sensation in skin lesions and disfigurement
      - Confirmed by presence of acid-fast bacilli (AFB) or acis fast rods (AFR) in samples
    - - Treatment may be lifelong for some patients
- - - - Pleomorphic bacillus
      - Obligate/ forced parasite of humans and some animals that takes up space in mucous membranes of humans and animals
      - At one time it was thought that it caused the flu pandemics in 1890 and 1918-
      - Most strains of H influenza have a capsule that resists phagocytosis
      - Different Haemophilus strains distinguished by capsular antigens
      - Prior to vaccination most diseases in the US were caused by H. influenzae type b
      - Haemophilus influenzae disease is a name for any illness caused by bacteria called H. influenzae. Some of these illnesses, like ear infections, are mild while others, like bloodstream infections, are very serious. In spite of the name, H. influenzae do not cause influenza (the flu).~ CDC
    - - Gram-positive coccobacillus found in soil, water, animals- like birds, fish, & insects
      - It is cold tolerant and can grow in refrigerated drinks and food like deli meats, hot dogs, soft cheese and yogurt
      - Enters the body in contaminated food or drink
      - Rarely pathogenic in healthy adults
      - Meningitis can occur in pregnant women, fetuses, newborns, and the elderly or immunocompromised
      - Only mild like flu s/s
      - Production of listeriolysin O protects the bacteria from phagocytic digestion
    - - Also known as Lancefield group B streptococcus
        
        Due to its B antigen
      - Normal vaginal microbiota in some 1/3 of women
      - The bacteria makes a protective capsule allows bacteria to avoid phagocytosis when it gets into the blood
      - Causes bacteremia, pneumonia, and meningitis in newborns
  - - - Since then cases have been reduced by as much as 90%
    - - Spreads among individuals in barracks and dorms
      - 9-23 more times prevalent in students living in dorms
      - Mortality is 100% if left untreated but 11% in pts who have been treated properly
    - - This could result in premature delivery, miscarriage, stillbirth, or meningitis in newborn