Answer the following questions based on the Chapter 10 \"Infectious Diseases: Tu
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Answer the following questions based on the Chapter 10 "Infectious Diseases: Tuberculosis and Leprosy" from Ortner, D. J. 2003. Identification skeletal remains. Academic Press. You can also refer to Aufterheide: 150-154 (leprosy) and 133-141 (TB). 1. Which species/strands of Mycobacterium can cause tuberculosis and leprosy in humans? 2. Describe the general pattern of bone lesions, typical for tuberculosis. Which bones does it affect the most frequently and in what way? 3. Describe the general pattern of bone lesions, typical for leprosy. Which bones does it affect the most frequently and in what way? 4. Summarize the theories explaining the origins of tuberculosis and leprosyExplanation / Answer
ANSWER 1) Tuberculosis is caused by Mycobacterium Tuberculosis. It is small aerobic nonmotile bacillus. The high lipid content of this bacteris is its unique clinical characteristics. It is gram positive and acid fast bacillus, can be cultured in laboratory also.
Leprosy is caused by Mycobacterium Leprae. It is an intracellular, acid fast bacterium,aerobic and rod shaped. It is surrounded by waxy cell member which the clinical characteristic of the organism. It is unculturable in laboratory.
ANSWER 2) TUBERCULOSIS:
The pattern of bone lesion may be fragmentary, osteolytic, localized, sclerotic and subperiosteal. CT shows calcification with cold abscess or visualizes epidural lesions with bone fragments.
The bone lesions in tuberculosis is mainly localized in dorsal region of spine and sacroillac joints. It may also be found in cervical, thoracic and lumbar spine. Usually weight bearing long bones are affected.
The primary infection site may be pulmonary or genitourinary tract. The infection spreads via arterial or venous route or lymphatic drainage. An arterial arcade is present in each subchondral region of vertebra which is a rich vascular plexus. This facilitates hematogenous spread of infection to the paradiskal regions. Batson's paravertebral venous plexus and intraosseous venous system is also responsible for transmission of the disease.
LEPROSY:
Leprosy mainly effects the bones of fingers, feet and maxilla. Phalenges, metatarsals and tibial crest are its major site.
The pattern of bone lesion is as granulomatous lesion that is osteolytic in nature. This pattern is seen as leprous dactylitis, concentric absorption and tarsal disintegration. Specific bone changes seen are formation of bone cyst, honeycombing, enlarge nutrient formina,subarticular erosionand primary periosteitis.
The healing process in leprosy is by sclerosis that formation of granulation tissue. This granulation tissue invades the cortex of the bone as tongue like processes and gradually destroys the bony traberculae with subsequent absorption leading to formation of carious lesions. The new osteoid tissue gets desroyed and is replaced with the fibrous tissue.
ANSWER 3) The tuberculosis infection was discovered in human remains from Neolithic era dating 9000 years ago. Tuberculosis is considered as the first disease known to mankind. The evidence of the infection is found in Egyptian mummies dated around 3000-2400 BC. The presence of infection among these mummies indicated the presence of hospital for tuberculosis in Egypt as early as 1500 BC. A study in August 2014 reveals that tuberculosis was spread via seals that contracted it on beaches of Africa, from human via domestic animals and carried it across the Atlantic. In the seventeen and eighteenth century, Franciscus Sylvius began differentiating between various forms of tuberculosis. By te end of nineteenth century several breakthrough gave hope that cause and cure can be found. In 1869, the disease was proved to be contagious and in 1882, Robert Koch revealed that the disease was due to infectious agent. By twentieth century, tuberculosis was a leading disease of UK. In 1906 was the first vaccine of tuberculosis found called BCG by Albert Calmette and Camille Guerin. Various other discoveries to find the treatment meausres was carried out but in 1980, the rise of drug resistant strains was found.
Leprosy has tormented human throughout the recorded history. The old testment decribes an assumptive disease which was as a result of curse from God and called to be leprosy. The leprosy was first documented by Egyptian Papyrus around 1550 BC. Around 600 BC Indian writings also describes a disease similar to leprosy. In Europe leprosy was first found in the records of ancient Greece after the army of Alexander the great came back from India and then in Rome in 62 BC.In 1873 Hansen discovered the germ Mycobacterium Leprae. In early 20th century, the doctors used the oil of Chaulmoogra nut plant to treat leprosy. In 1941, Promin a sulfone drug was introduced to treat leprosy. In 1950's dapsone pills became treatment of choice. In 1970, the first multidrug treatment was invented. Now MDT with combination of dapsone, rifampicin and clofazimine is the drug for treatment of leprosy.
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