Mycobacterium (1)
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Transcript of Mycobacterium (1)
Mycobacterium
Dr. J Sheehama
UNAM School of Medicine
Tuberculosis is a
leading cause of death
worldwide (~1.4
million)*
Namibia
Population: 2.1 million
In 2009: TB case
notification rate of 634
per 100 000**
In 2010: TB case
notification rate of 589
per 100 000
*WHO
** MoHSS
Introduction and background
• Pulmonary TB is caused by Mycobacterium tuberculosis
– Lung is the prime target for infections
• TB is one of the opportunistic infections in HIV-AIDS patients
Introduction and background information
Introduction and background
• Transmission of TB
Mycobacterium tuberculosis
Mycobacterium leprae (uncommon)
Mycobacterium avium-intracellulaire Complex
(MAC) or (M. avium)
Important Human Pathogens
Lipid-Rich Cell Wall of Mycobacterium Mycolic acids
CMN Group: Unusual cell wall
lipids (mycolic
acids,etc.)
(Purified Protein Derivative)
Acid-Fast (Kinyoun) Stain of
Mycobacterium
NOTE: cord growth (serpentine
arrangement) of virulent strains
Photochromogenic Mycobacterium
kansasii on Middlebrook Agar
NOTE: Mycobacteria pathogenic
for humans can be differentiated
(Runyon Groups) by:
speed of growth (all are
slower than most other
pathogens) and by
production of chromogenic
pigments (in light, in dark,
or none)
Improved Mycobacterial Isolation Medium
Eight Week Growth of
Mycobacterium tuberculosis on
Lowenstein-Jensen Agar
Pathogenic Mycobacterium spp.
BCG
AIDS
patients
Mycobacterial Clinical Syndromes
Diagram
of a
Granuloma
NOTE: ultimately a
fibrin layer develops
around granuloma
(fibrosis), further
“walling off” the
lesion.
Typical progression
in pulmonary TB
involves caseation,
calcification and
cavity formation.
Laboratory Diagnosis of
Mycobacterial Disease
Nucleic acid probes
Nucleic acid sequencing
Differential Characteristics of
Commonly Isolated
Mycobacterium spp.
Mycobacterium
tuberculosis
Mycobacterium
tuberculosis
Infections
Incidence of Tuberculosis in USA
Mycobacterium
tuberculosis
Infections (cont.)
BCG (bacille Calmette-Guerin)
= attenuated M. bovis
Positive PPD + Chest X-Ray +
MDR-TB a serious
global health threat
Pneumonia
Granuloma formation with fibrosis
Caseous necrosis • Tissue becomes dry & amorphous (resembling cheese)
• Mixture of protein & fat (assimilated very slowly)
Calcification • Ca++ salts deposited
Cavity formation • Center liquefies & empties into bronchi
Typical Progression of
Pulmonary Tuberculosis
PPD Tuberculosis Skin Test Criteria
PPD = Purified Protein Derivative from M. tuberculosis
Chest X-Ray of Patient with Active
Pulmonary Tuberculosis
Mycobacterium Tuberculosis
Stained with Fluorescent Dye
Mycobacterium leprae
Mycobacterium leprae Infections
Mycobacterium leprae Infections (cont.)
Tuberculoid vs. Lepromatous Leprosy Clinical Manifestations and Immunogenicity
Lepromatous vs. Tuberculoid Leprosy
Lepromatous Leprosy (Early/Late Stages)
Lepromatous Leprosy Pre-
and Post-Treatment
Clinical Progression of Leprosy
Effect of Cell-Mediated Immunity on
Leprosy Clinical Outcome
Mycobacterium avium-
intracellulaire Complex
(MAC)
Mycobacterium avium-intracellulaire Infections
Mycobacterium avium-intracellulaire Infections
M. avium-
intracellulaire
Complex (MAC)
Progression vs.
CD4 Count in
AIDS Patients
Mycobacterium avium-intracellulaire in
Tissue Specimens
Low Magnification High Magnification
REVIEW of
Mycobacterium
Mycobacterium tuberculosis
Mycobacterium leprae (uncommon)
Mycobacterium avium-intracellulaire Complex
(MAC) or (M. avium)
Important Human Pathogens
REVIEW
Lipid-Rich Cell Wall of Mycobacterium Mycolic acids
CMN Group: Unusual cell wall
lipids (mycolic
acids,etc.)
(Purified Protein Derivative)
REVIEW
Pathogenic Mycobacterium spp.
BCG
AIDS
patients
REVIEW
Mycobacterial Clinical Syndromes
REVIEW
Diagram
of a
Granuloma
NOTE: ultimately a
fibrin layer develops
around granuloma
(fibrosis), further
“walling off” the
lesion.
Typical progression
in pulmonary TB
involves caseation,
calcification and
cavity formation. REVIEW
Review of Mycobacterium
tuberculosis
Mycobacterium
tuberculosis
Infections
REVIEW
Mycobacterium
tuberculosis
Infections (cont.)
BCG (bacille Calmette-Guerin)
= attenuated M. bovis
Positive PPD + Chest X-Ray +
MDR-TB a serious
global health threat
REVIEW
Pneumonia
Granuloma formation with fibrosis
Caseous necrosis • Tissue becomes dry & amorphous (resembling cheese)
• Mixture of protein & fat (assimilated very slowly)
Calcification • Ca++ salts deposited
Cavity formation • Center liquefies & empties into bronchi
Typical Progression of
Pulmonary Tuberculosis
REVIEW
Review of Mycobacterium leprae
Mycobacterium leprae Infections
REVIEW
Mycobacterium leprae Infections (cont.)
REVIEW
Lepromatous vs. Tuberculoid Leprosy
REVIEW
Lepromatous Leprosy (Early/Late Stages)
REVIEW
Clinical Progression of Leprosy
REVIEW
Effect of Cell-Mediated Immunity on
Leprosy Clinical Outcome
REVIEW
Review of Mycobacterium avium-
intracellulaire Complex
(M. avium)
Mycobacterium avium-intracellulaire Infections
REVIEW
Mycobacterium avium-intracellulaire Infections
REVIEW
M. avium-
intracellulaire
Complex (MAC)
Progression vs.
CD4 Count in
AIDS Patients
REVIEW
Home work – Due
25/02/2015
– describe the risk factors
of TB infection in your
Region