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Phagocytosis:
Leukocytes
Intracellular Killing
neutrophils
active in initial infection
can enter tissues
↑ if bacterial
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Leukocytes Leukocytes
eosinophils basophils
somewhat phagocytic release histamine
↑ if parasites or allergy role in allergies & inflammation
Leukocytes Leukocytes
monocytes lymphocytes
mature into macrophages (phagocytic) part of adaptive immunity: B and T cells
↑ if viral
monocytes 2-10%
eosinophils 1-6%
basophils 0-1%
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leprosy leprosy
etiologic agent two forms:
Mycobacterium leprae tuberculoid
• "anesthetic"
• acid-fast (waxy cell wall) bacterium
• affects skin pigment
• intracellular infection (macrophages) • nerve damage
• v. slow growing • incubation: 2-5 years
leprosy leprosy
two forms: diagnosis
lepromatous skin scraping
• granulomas • acid fast stain
• due to host cellular
defenses: macrophages won't grow in lab*
“wall off”
• incubation: 9-12 years
leprosy
treatment
long-term antibiotics* (6-12 mos.)
• MDT (multi-drug therapy) *
offered free in endemic countries
no vaccine
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“white plague”
Death
Recovery
Tuberculosis Tuberculosis
pulmonary TB extrapulmonary TB
many asymptomatic = latent TB children, immunosuppressed pts.
mycobacteria in macrophages • bones, meningitis, urogenital etc.
granulomas: walled off “tubercles” miliary TB
• bacteria dormant, noninfectious • systemic spread
can reactivate and/or spread • most fatal
Tuberculosis Tuberculosis
control
screening
• Mantoux (tuberculin) test
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Tuberculosis Tuberculosis
control control
treatment vaccine
• antibiotics, long-term (6-9 months – “regular” TB) • BCG (Bacillus Calmette-Guerin)
• not in U.S. – worldwide commonly used in children
• Variable effectiveness
Tuberculosis Tuberculosis
drug-resistance
MDR-TB (multiple)
• resistant to top 2 drugs (rifampicin & isoniazid)
XDR-TB* (extensively)
• resistant to 3 of 6 drugs
TDR-TB (totally)
• resistant to ALL current drugs