Leprosy- Diagnosis

Leprosy- Diagnosis


Bacteriological Index For Leprosy 

  • It is a rough index expressing probable number of acid fast bacilli for standardized microscopic field in skin smear.
  • It is indicative of the load of bacteria at the site from which smear is taken.
  • It does not differentiate between live and dead bacilli.
  • It is not an indication of total bacillary load in the body.
  • Ridleys scale is followed to calculate the bacterial index.
  • = no bacilli in 100 fields
  • 1+ = 1 – 10 bacilli in 100 fields
  • 2+ = 1 – 10 bacilli in 10 fields
  • 3+ = 1 – 10 bacilli in 1 fields
  • 4+ = 10 – 100 bacilli in 1 field
  • 5+ = 100 – 1000 bacilli in 1 field
  • 6+ = >1000 bacilli in 1 field. 

Lepromin test 

  • Not diagnose leprosy nor inditicate prior contact.

SMEAR SAMPLE

  • A minimum of seven sites should be examined
  1. Smears from 4 skin lesion
  2. Smears from both ear lobes
  3. One nasal swab
  • Sample from the skin should be obtained from the edges of the lesion rather than from the centre.

Uses

  • To classify the lesion

Tuberculiod

Positive

Lepromatous

Negative

Boderline

Variable

  •  To assess the prognosis
  1. Positive is Good prognosis
  2. Negative  is Bad prognosis
  3. Conversion to lepromin positive during treatment is evidence of improvement.
  •  To assess the resistance of individuals to leprosy.
  •  BCG vaccination can convert lepra reaction from negative to positive

SLIT SMEAR

Leprosy type

Slit Smear

Infectivity

Tuberculoid

AFB may be found from margin

-ve

Boderline

AFM found

infective

Lepromatous

Teeming with AFB

infective

Exam Question
 

Lepromin test 

  • Not diagnose leprosy nor inditicate prior contact.

SMEAR SAMPLE

  • A minimum of seven sites should be examined
  1. Smears from 4 skin lesion
  2. Smears from both ear lobes
  3. One nasal swab 
  • Sample from the skin should be obtained from the edges of the lesion rather than from the centre.

Uses

  • To classify the lesion

Tuberculiod

Positive

Lepromatous

Negative

Boderline

Variable

   To assess the prognosis

  1. Positive is Good prognosis
  2. Negative  is Bad prognosis
  3. Conversion to lepromin positive during treatment is evidence of improvement.
  •  To assess the resistance of individuals to leprosy.
  •  BCG vaccination can convert lepra reaction from negative to positive

SLIT SMEAR

Leprosy type

Slit Smear

Infectivity

Tuberculoid

AFB may be found from margin

-ve

Boderline

AFM found

infective

Lepromatous

Teeming with AFB

infective

Don’t Forget to Solve all the previous Year Question asked on Leprosy- Diagnosis

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