Light and electron microscopic appearances of peripheral nerves from two lepromatous leprosy patients after 12 months of multidrug therapy and their significance.

Biopsies from radial cutaneous nerves of a lepromatous patient and one borderline lepromatous patient treated with 12 doses of multidrug regimen were studied using light and electronmicroscopes. Histopathologically both showed typical lepromatous neuritis. Electronmicroscopic examination showed demyelination, atrophy and degeneration of myelinated axons and nonmyelinated axons and a marked increase in collagen fibrils. Perineurial cells, Schwann cells and endoneurial macrophages contained numerous persisting M. leprae. Almost all the organisms in macrophages were fragmented and could be considered non-viable. A few M. leprae found in Schwann cells showed structure of viable bacilli. It is possible a few dead or dormant organisms may persist for many years in Schwann cells or in fibrous tissue without producing any ill effects, and may cause relapse only in rare instances. Since 12 months of MDT resulted in the clearance of M. leprae in course of time and the reported relapse rates after years were insignificant, implementation of MDT for a year for all MB patients is justified provided surveillance of these patients is ensured. Administration of uniform MDT for 6 months is worth a trial.

Phagocytosis of Mycobacterium leprae by cardiac muscle cells--a preliminary report.

Fetal cardiac muscle cells were shown to ingest M. leprae easily within 20 minutes of exposure in vitro. This phagocytosis is considered nonspecific and facilitated by the lipid coat of the mycobacteria. The presence of M. leprae free in the cytoplasm of the muscle cells did not seriously affect the morphology or rhythmic contractions of the cells. The significance of the presence of M. leprae in somatic cells needs further study.

First lesion in experimental armadillo leprosy.

Eighteen armadillos were infected intravenously with 10(8) M. leprae and 10 intracutaneously with 10(7) M. leprae. Among those which developed disseminated disease, a nodule at the site of inoculation was the first lesion noticed in 14 of the 16 infected intravenously and 4 of the 4 infected intradermally. It is possible that in human leprosy the first sign of infection is localized proliferation of M. leprae at the site of entry, and even nodule formation in lepromatous patients. It may be important to search for asymptomatic swelling or keloid-like lesions in skin or in nasal mucosa while screening a population for early leprosy.