ASSIGNMENT

MED-401 (Systemic Medicine-I)

PMAS-AAUR

BUFFALO LEPROSY

Submitted To:
Dr. Muhammad Yaqoob

Submitted By:
ALTAF HUSAIN 08-arid-282

DVM 7th

FV&AS
Pir Mehar Ali Shah Arid Agriculture University Rawalpindi

BUFFALO LEPROSY
Contents
1. Other names 2. Definition 3. Types 4. Etiology 5. Susceptible Host 6. Transmission 7. Pathogenesis 8. Lesions 9. Clinical Findings 10. Diagnosis 11. Differential Diagnosis 12. Treatment 13. Prevention

Other Names
1. 2. 3. 4. Hansens Disease Hanseniasis Lepra Bubalorum Lepra Bovina

Definition
A disease of water buffalo characterized by persistent coetaneous and subcutaneous nodule on the legs and lower parts of the abdomen and thorax. It is of particular interest because of the similarity of its histological features to those of human leprosy.

Types
A chronic intracellular infectious disease of zoonotic impotance. Usually it is not fatal. The manifestations of the disease depend on the resistance of the host. Types: 1. Tuberculoid - host is highly resistant, clinical abnormalities limited to a few peripheral nerves and adjacent skin areas, tuberculoid granuloma 2. Lepromatous - host lacks resistance, all tissues affected, foam cell granuloma 3. Borderline - between tuberculoid and lepromatous

Etiology
This is caused by 1. Mycobacterium leprae 2. Mycobacterium leprae bubalorum This bacteria is from the same family mycobacteriaceae which cause Johns disease in bovines. This is a acid fast staining and rod shaped bacteria.

Susceptible Host
1. Water Buffalo 2. Cattle; Holstein-Freisen 3. Human

Transmission
It is thought to be transmitted by; Respiratory Droplets Nasal discharges Skin sores Contaminated objects Arthropods. Only 5% of those exposed acquire the disease.

Pathogenesis
Like other mycobacteria , Mycobacterium leprae has a difficult time replicating outside of host cells. Some researchers maintain that it is a facultative intracellular parasite, others say that the bacteria cannot replicate at all outside of the cell. The former are somewhat supported by the fact that M. leprae has never been cultured in vitro. When M. leprae can find a host, it is a very slowly replicating bacteria that can take up to 13 days to undergo one replication cycle. Leprosy is characterized by bacterial replication inside intracellular vesicles of macrophages, Schwann cells, and endothelial cells. In general, M. leprae prefers such cells at lower temperatures than that of the animal body, which is why it tends to manifest itself near the skins surface. From the onset, small cutaneous nerve fibers are involved. With bacillary multiplication, contiguous skin areas, including autonomic nerve fibers, dermal appendages, and blood vessels, are invaded.

Lesions
The contaneous nodules results from accumulation of large number of epitheloid cells in the dermis. Microscopically, these individually discrete cells are seen to have greatly distended, foamy, often vacuolated cytoplasm in which numerous acid fast bacilli are demonstrable. The large vacuoles are believed to be the result of lipid production by the bacilli and are identical to these in the large lepra cells of the bacilli of human leprosy. Giant cells of langhans type may be seen, but caseation necrosis and calcification do not occur. The gross appearance of lesions is not distinctive. A solid uniform module with a diameter as great as 4 to 5 cm may be firmly attached to the dermis and elevate the epidermis.

Clinical Findings
Coetaneous lesions and involvement of peripheral nerves being the cardinal clinical signs. Among these presentation, systemic involvement including mucous membranes of upper respiratory tract and eyes is rarely reported even if it is still commonly seen in endemic areas, in particular lepromatous leprosy.

Diagnosis
In countries where the disease occurs, the diagnosis can be made on the basis of the collections of Lepra Cells in the dermis, these cells being laden with acid-fast bacilli. 1. Clinical signs and symptoms 2. Histological examination has revealed also that nerves in the foot-pad tissues and the correspondin sciatic nerve are infected. 3. Microbiological arrangement of the acid fast baccili of the infectious agent in the affected tissues. 4. Mice inoculation

Differential Diagnosis Treatment

1. Onchocercosis;called skin tuberculosis 2. Muscular necrosis (Roeckl's granuloma The treatment is prolonged for a long time upto six months. Drug of choice for leprosy is Dapsone which is Diaphenylsulfone.

1. Anti biotic theropy; Diaphenylsulfone 50 mg/kg of body weight Levofloxacin 3mg/kg of body weight 2. Non steroidal anti inflammatory Drugs(NSAIDS) Flunixin Meglumine 1.1 mg/kg of body weight

Prevention
1. 2. 3. 4. 5.

Early detection of infected animals Isolate or cull the infected animals Improves the sanitation conditions and managemental practices at the farm Adopt the multiple drug theropy (MDT) practice This is a zoonotic disease, so avoid human contact with animals. It is better to cull the infected animal.