Lepra

Zusammenfassung

Lepra ist eine chronische bakterielle Infektionskrankheit durch Mycobacaterium leprae, derzeit leiden weltweit ca. 3 Millionen Personen. Lepra ist nicht hoch kontagiös, für die Übertragung steht die Tröpfcheninfektion im Vordergrund. Die vielfältigen klinischen Symptome sind durch den Immunstatus des Betroffenen, die aktuelle Bakterienladung sowie Bestandsdauer der Krankheit vor der Diagnosestellung bestimmt. Zwecks Behandlungsstrategie wird die Krankheit in bakterienarme (tuberkuloid, borderline-tuberkuloid) und bakterienreiche (borderline-borderline, borderline-lepromatöse und lepromatöse) Formen unterteilt. Erregernachweis erfolgt durch mikroskopisches Direktpräparat, Histopathologie bzw. mittels PCR. Die Kombinationstherapie mit Dapson, Rifampicin und Clofazimin gilt als Standard (WHO).

Abstract

Leprosy is a chronic infectious disease caused by the bacillus Mycobacterium leprae. The skin and peripheral nerves are the most affected organs. Although not highly contagious, leprosy is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases. Its geographical distribution has differing strongly with time and it is now endemic in tropical and subtropical regions only. The unequal presentations of the disease (Ridley-Jopling and WHO classifications) are correlated with the immune response, bacillary load, and by the delay before diagnosis. The diagnosis of leprosy is mostly made from the clinical picture, however, must ever be confirmed by direct specimen slide and histopathology. Leprosy is treated by default with a multidrug (MTD) combination of rifampicin, clofazimine, and dapsone. Two main regimens are implement conditionend on whether the patient has paucibacillary or multibacillary leprosy.

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