Pharyngeal leprosy
Introduction
Pharyngeal leprosy introduction Leprosy is a contact infectious disease caused by M. leprae, which is mainly caused by invasion of skin, mucous membranes and peripheral nerves. It can also affect deep tissues and organs. Leprosy enters the body mainly through damaged skin and mucous membranes. The disease is not transmitted, not genetic. Most of the leprosy lesions occur in the nose. Sometimes, before the systemic symptoms appear, a large number of leprosy bacteria can be found in the nasal secretion smear. The infection is extremely strong, and the pharyngeal leprosy is rare. Most of them are nasal tumor-type leprosy. In addition to the initial stage of pharyngeal mucosa can be acute edema, generally nodular infiltration, mucosal dry atrophy, uvula, hard palate, soft palate, zygomatic arch and tonsil can occur in nodular infiltration, lesion destruction The defect, the scar is often radial, the patient's pharyngeal reflex disappears, open nasal sound, but does not feel pain. Invasion of the auricular nerve can cause thickening and thickening. The facial nerve can be stimulated by the invasion of the lesion. It can also cause peripheral facial paralysis due to lesion compression. The sputum and facial paralysis exist simultaneously. This is the characteristic of leprosy facial paralysis. basic knowledge The proportion of illness: 0.03% Susceptible people: no specific population Mode of infection: contact spread Complications: facial paralysis
Cause
Pharyngeal leprosy etiology
Cause of disease
Caused by infection with M. leprae.
Pathophysiology
In addition to the initial stage of pharyngeal mucosa can be acute edema, generally nodular infiltration, mucosal dry atrophy, uvula, hard palate, soft palate, zygomatic arch and tonsil can occur in nodular infiltration, lesion damage Defect scars are often radial.
Prevention
Pharyngeal leprosy prevention
To control and eliminate leprosy, we must adhere to the principle of prevention first, implement the principle of active prevention and control, control infection, and implement the practice of investigating, segregating, and treating. To detect and control the source of infectious diseases, cut off the route of infection, give regular medications, and improve the immunity of the surrounding natural population, in order to effectively control infection and eliminate leprosy.
Complication
Pharyngeal leprosy complications Complications
Invasion of the auricular nerve can lead to thickening and thickening, facial nerve can be stimulated by the invasion of the lesion, and peripheral facial paralysis can also occur due to lesion compression. Both sputum and facial paralysis exist, which is characteristic of leprosy facial paralysis. Secondly, M. leprae can also infect other parts. For example, the infection of the limb can cause morphological abnormalities. The main complication of this disease is to cause limb function and disability, so the complications of this disease are very serious. Because it is contagious, it should be actively isolated.
Symptom
Pharyngeal leprosy symptoms common symptoms pharyngeal burning pain pharyngeal apple-like nodules pharyngeal congestion pharyngeal ulcer peripheral nerve damage
According to the history of exposure to leprosy, chronic disease, systemic skin, mucosa and peripheral nerve damage, lesions are all secretions or biopsy, can be diagnosed by finding leprosy, and advanced leprosy must be differentiated from tuberculosis and syphilis.
Most of the leprosy lesions occur in the nose. Sometimes, before the systemic symptoms appear, a large number of leprosy bacteria can be found in the nasal secretion smear. The infection is extremely strong, and the pharyngeal leprosy is rare. Most of them are nasal tumor-type leprosy. In addition to the initial stage of pharyngeal mucosa can be acute edema, generally nodular infiltration, mucosal dry atrophy, uvula, hard palate, soft palate, zygomatic arch and tonsil can occur in nodular infiltration, lesion destruction The defect, the scar is often radial, the patient's pharyngeal reflex disappears, open nasal sound, but does not feel pain.
Invasion of the auricular nerve can cause thickening and thickening. The facial nerve can be stimulated by the invasion of the lesion. It can also cause peripheral facial paralysis due to lesion compression. The sputum and facial paralysis exist simultaneously. This is the characteristic of leprosy facial paralysis.
Examine
Examination of pharyngeal leprosy
First, the leprosy inspection
Active skin lesions were printed with acid-proof stains, TT was mostly negative, and LL was positive. Mainly from the skin and mucous membranes, if necessary, can be used for lymph node puncture. Skin investigation: Choose to have activity, skin damage, and disinfect the skin. Wear sterile gloves during the examination. Use the left thumb and the two fingers to squeeze the patient's skin to make the local skin whiten. Then, use the right hand to remove the knife and cut a 5 mm long, 3 mm deep incision. Use the blade to scrape the tissue fluid. Apply to the slide, fix acid-resistant staining and microscopic examination. The incision cotton ball is pressed, and the number of parts taken depends on the need.
Second, histopathological examination
Histopathological TT is mainly characterized by epithelial-like cell infiltration around small vascular vessels and nerves. Acid-fast bacilli are often not detected by acid-fast staining. LL is characterized by granuloma containing foam cells (ie leprosy cells) in the dermis, and acid-fast staining shows foam. There is a large amount of leprosy in the cells. Because there is no invasion of the superficial layer of the dermis, there is no infiltration zone between the epidermis and the dermis.
The leprosy test: The leprosy test was used to determine the delayed type hypersensitivity of the body to M. leprae. TT was strongly positive, while LL was mostly negative. It is a simple method for determining the body's resistance to M. leprae, which can partially reflect the strength and presence of the body's immune response to M. leprae cells. The types of leprosy are crude leprosy, pure bacillus, and pure protein leprosy. The current general is crude leprosy (also known as intact leprosy).
Diagnosis
Diagnosis and diagnosis of pharyngeal leprosy
diagnosis
According to the history of exposure to leprosy, chronic disease, systemic skin, mucosal or peripheral nerve damage, take secretions or biopsy at the site of the lesion, and find the leprosy to confirm the diagnosis.
Differential diagnosis
Late leprosy must be differentiated from tuberculosis and syphilis.
