Lepromatous leprosy is a highly contagious chronic infection that affects the skin, nerves, and other organs. It is caused by Mycobacterium leprae and can lead to physical deformities if left untreated. Treatment involves antibiotics and surgery, and early diagnosis is crucial.
Lepromatous leprosy is a chronic infection caused by the bacterium Mycobacterium leprae. Most forms of leprosy affect the skin and peripheral nerves, but usually leave the rest of the body’s organs unharmed. Lepromatous leprosy also affects the skin and nerves, but affects other organs, including the nose, eyes, testicles, and bones.
All forms of leprosy are contagious to some degree, depending on the burden, or quantity, of the organism in the body’s tissues. Lepromatous leprosy is one of the most contagious, because it carries the greatest burden, reaching up to seven billion organisms per gram of tissue. By comparison, nonlepromatous leprosy carries fewer than a million organisms per gram. The disease is transmitted through the skin and mucous membranes of the nose.
Before medical advances, leprosy was often referred to as a curse and sufferers were sent to live in isolation for fear of spreading the disease. Today, leprosy still affects more than 200,000 people a year, mostly in Asia, Africa and South America, but most people have naturally acquired immunity to the bacteria. In cases of lepromatous leprosy, patients typically have little or no resistance to the bacteria and their bodies are ill-equipped to mount a response to the infection. In these patients, defense cells that typically destroy bacteria, called macrophages, work against the host, allowing the bacteria to multiply within the cell. Macrophages also provide transport for bacteria, allowing them to infect other areas of the body.
Early symptoms of lepromatous leprosy include stuffy nose or bleeding and swelling of the legs and ankles. Numerous lesions, papules and nodules can be seen through the skin. Unlike other forms of leprosy, early nerve damage can go unnoticed. Early diagnosis is essential for the treatment of this form of leprosy.
Left untreated, lepromatous leprosy can cause a wide range of complications that affect different organs. The skin on the eyebrows, forehead and earlobes may thicken and the eyelashes may fall out. The skin on the legs can thicken and form ulcers. In males, the testicles can shrivel up, leading to infertility. Sensitivity to light, glaucoma and blindness may occur in the eyes. The disease can also affect the larynx and internal organs.
Treatment of lepromatous leprosy focuses on stopping the infection and reducing the potential for physical deformities. Antibiotics, sometimes several at a time, are given to kill bacteria, and oral corticosteroids can help reduce swelling. Some patients may require surgery to drain abscesses and repair damaged nerves or tissue. Patients should be educated on how to take the drug, as it is essential to complete the entire antibiotic regimen. Once treatment is started, the disease is no longer infectious.
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