Upload
harshad-deshpande
View
2.015
Download
0
Embed Size (px)
DESCRIPTION
its a lecture of 2nd mbbs students which i have taken in last week.. hope u will enjoy it
Citation preview
Examples of Chronic Inflammation
• Tuberculosis Leprosy, Syphilis, Cat scratch
disease, Granuloma inguinale, Tularemia
• Fungal- Actinomycosis, Blastomycosis, Cryptococosis
• Parasitic- Schistosomiasis
• Sarcoidosis, Crohns, Foreignbody.
?
The
Organism?How it enters in the body?
Which organs are affected?
Changes in the organs, Gross & Microscopy Complications and
fates of disease
How to make a Diagnosis ?
Leprosy ~
Hansen’s disease
Mycobacterium leprae
less acid fast .
Transmission
Slow communicable
Incubation period – 3 yrs
Slow transmission
Route :
‘Direct contact’
Organs involved
Classification
Lepromatous
Tuberculoid
• T Lymphocytes
• IFN-Gamma • Macrophages • epitheloid • giant cells.
Modified Ridley &
Jopling’s classification
• TT – Tuberculoid polar• BT – Borderline tuberculoid• TI -- Tuberculoid indeinite• BB – Mid borderline• LI – Lepromatous indefinite• BL – Borderline lepromatous• LL – Lepromatous polar
Other types:
1.Pure neural2.Histoid3. Indeterminate
Lepromatous leprosy
Symmetrical,
Multiple,
Hypopigmented lesions
Leonine faces
Pts Immunity – down
Sensory deficit – less severe
Histology
Foamy cells in the dermis, separated from Epidermis by Clear zone
Tuberculoid leprosy
Single or few asymmetrical ,
Sensory impairment
HistologyTubercle,
dermal nerves,
No clear zone, few bacilli
Lab Diagnosis
To show the organism
Skin clipping
Stains-
ZN, Fite Faraco,
Gomori methenamine silver
Culture
9 Banded Armadilo
Reactions in Leprosy
Lepra type I
Lepra type II
Lepra type I
Upgrading reaction
Downgrading reaction
• TT – Tuberculoid polar• BT – Borderline tuberculoid• TI -- Tuberculoid indeinite• BB – Mid borderline• LI – Lepromatous indefinite• BL – Borderline lepromatous• LL – Lepromatous polar
Lepra type 2
Erythema nodosum Leprosum
In Lepromatous patient
after treatment
Tender nodules, fever, synovitis,
Lymphnode enlargement
Lepromin test
Not for Diagnosis
For classifying Leprosy
Depending on immune response.
24-48 Fernandez
3-4 wks Mitsuda reaction
Baba Amte
Actinomycosis
Mycosis…Is it a fungus?
No
Anaerobic
Bacteria
Actinomycetes israelii.
Commensal organism.
Endogenous infection.
Types depending on sites
CervicofacialThoracic
AbdominalPelvic