02137nas a2200241   4500000000100000008004100001653003100042653002500073653002400098653001200122653002400134100001000158700001100168700001300179700001300192245010600205856007000311300001100381490000800392050001300400520146800413022001401881       2014                            d10aMycobacterium lepromatosis10aMycobacterium leprae10aMolecular diagnosis10aleprosy10aGeographic medicine1 aHan X1 aAung F1 aChoon SE1 aWerner B00aAnalysis of the Leprosy Agents Mycobacterium leprae and Mycobacterium lepromatosis in Four Countries.  uhttp://ajcp.oxfordjournals.org/content/ajcpath/142/4/524.full.pdf  a524-320 v142  aHAN 20143 a<p><strong>OBJECTIVES: </strong>To differentiate the leprosy agents Mycobacterium leprae and Mycobacterium lepromatosis and correlate them with geographic distribution and clinicopathologic features.</p>

<p><strong>METHODS: </strong>Species-specific polymerase chain reactions were used to detect each bacillus in archived skin biopsy specimens from patients with leprosy from Brazil (n = 52), Malaysia (n = 31), Myanmar (n = 9), and Uganda (n = 4). Findings were correlated with clinical and pathologic data.</p>

<p><strong>RESULTS: </strong>Etiologic species was detected in 46 of the 52 Brazilian patients, including 36 patients with M leprae, seven with M lepromatosis, and three with both bacilli. The seven patients with sole M lepromatosis all had tuberculoid leprosy, whereas only nine of the 36 patients infected with M leprae exhibited this type, and the rest were lepromatous (P &lt; .001). All patients with dual infections had lepromatous leprosy. Of the nine patients from Myanmar, six were test positive: four with M leprae and two with M lepromatosis. Of the Malaysian and Ugandan patients, only M leprae was detected in 27 of the 31 Malaysians and two of the four Ugandans.</p>

<p><strong>CONCLUSIONS: </strong>The leprosy agents vary in geographic distribution. Finding M lepromatosis in Brazil and Myanmar suggests wide existence of this newly discovered species. The leprosy manifestations likely vary with the etiologic agents.</p>
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