02570nas a2200433   4500000000100000008004100001260001300042653001500055653001000070653000900080653001900089653003000108653001100138653002200149653001100171653002300182653001200205653001600217653000900233653001600242653002500258653002200283653000900305653002200314653003000336100001300366700001500379700001600394700001000410700001100420700001200431245010900443856005900552300001000611490000700621050003200628520146200660022001402122       1999                            d  c1999 Sep10aAdolescent10aAdult10aAged10aBiopsy, Needle10aDrug Therapy, Combination10aFemale10aFollow-Up Studies10aHumans10aLeprostatic Agents10aleprosy10aLymph Nodes10aMale10aMiddle Aged10aMycobacterium leprae10aPeripheral nerves10aSkin10aTreatment Outcome10aWorld Health Organization1 aSharma A1 aSharma V K1 aRajwanshi A1 aDas A1 aKaur I1 aKumar B00aPresence of M. leprae in tissues in slit skin smear negative multibacillary (MB) patients after WHO-MBR.  uhttp://leprev.ilsl.br/pdfs/1999/v70n3/pdf/v70n3a08.pdf  a281-60 v70  aInfolep Library - available3 a<p>This study looked for M. leprae in the lymph node, nerve and skin of multibacillary (MB) leprosy patients who become slit skin smear negative after the completion of WHO-MBR. Twenty-five WHO-MBR-treated multibacillary leprosy patients were studied; borderline lepromatous (BL) leprosy (n = 11) and lepromatous (LL) leprosy (n = 14)). Fifteen patients had reaction (erythema nodosum leprosum 11, upgrading reaction 4) either at presentation or during therapy. All patients attained slit skin smear negativity after WHO-MBR (range 24-39 months. Sixteen (64%) patients with multibacillary leprosy showed fragmented bacilli in skin and nerve biopsy or lymph node aspirates after WHO-MBR. Lymph node aspirates alone revealed M. leprae in seven patients, followed by nerve in two and skin in one patient. Four cases showed M. leprae at all sites followed by nerve and skin or lymph node in one case each. A pretreatment bacteriological index (BI) of 4+ or more was significantly associated with the presence of M. leprae at the end of treatment. Also, significantly more lymph node aspirates contained M. leprae in comparison with nerve or skin biopsies. All seven cases in whom treatment was extended beyond 24 months showed M. leprae in tissues even after attaining slit smear negativity. In conclusion, M. leprae persist in tissues after 2 years of WHO-MBR and patients with an initial BI of 4+ or more need to be closely followed up after stopping MDT.</p>  a0305-7518