About 95% of all newly infected patients live in developing countries. See our Privacy Policy and User Agreement for details. But this one, I like best of all. The infection induces both humoral and cell mediated immunity; the circulating antibodies have no effect but the cell mediated immunity plays an important role for the response of the host for this infection. In this article we will discuss about Mycobacterium Leprae which causes Leprosy:- 1. Why does plant cell possess large sized vacuole? Lepra bacilli enter through damaged skin, cut, wound and nasal mucosa. Peripheral neuropathy may occur due to delayed hypersensitivity reaction to degenerated lepra bacilli. Currently NTM are classified according to their growth rate and are divided into slow-growing (SGM) and rapid-growing (RGM) mycobacteria. Dapsone (4.4′ diamino diphenyl sulphone) (DDS) mono-therapy was standard drug for all types of Leprosy till 1982. BCG vaccine seems to give some protection against leprosy in children of 0-15 years in countries where BCG vaccine was used against tuberculosis. This website includes study notes, research papers, essays, articles and other allied information submitted by visitors like YOU. There is also another type of skin testing reagent known as Leprosins which are ultrasonates of tissue-free bacilli from lesion. Thirty countries reported zero new cases. It is severe and its prognosis is poor due to deficient MI (Table) humoral antibodies against mycobacterial antigens are not protective. It is a localised form of the disease and found in patients with high degree of CMI and the skin is infiltrated with helper T-cells. Clinical Features of Mycobacterium Leprae: 6. Group I: photochromogen (strains producing pigments under the influence of light), slow-growing NTM (e.g. In the unlikely event that you have Hansen’s disease, your doctor can help you get treatment. Nasal discharge and skin lesion are the sources of infection. Ever since my years of high school, I really have no idea what professors are looking for to give good grades. Source: Courtesy of WHOExternal, United States National Hansen’s Disease ProgramExternal Ninety-two countries did not report, several of which are known to have cases of leprosy. Leprosy can occur at all ages from infancy to elderly, but is curable in which treatments can avert disabilities. Now customize the name of a clipboard to store your clips. NTM can be found ubiquitously in nature and show a broad diversity regarding where they can be found and how they adapted to certain environmental conditions. Hello! It cannot be predicted when and if reactivation occurs. After using your book for about 2 weeks, I started seeing results! The disease can affect the nerves, skin, eyes, and lining of the nose (nasal mucosa). Los niños son más propensos … Koch published his findings on March 24th 1882 in the Berlin Society of Physiology. this nerve damage may result in a lack of ability to feel pain, which can lead to the loss of parts of a person's extremities from repeated injuries or infection due to unnoticed. Also microscopic diagnostics of skin or nasal smears is often difficult as samples are false-negative in 70% of all cases. Mycobacteria can then persist in the body for several years as latent tuberculosis without causing any symptoms. bovis is resistant. Type of reaction elicited by Leprosins is similar to that of Lepromin: Erythema and induration of 10-30 mm in diameter is observed after 24-48 hours after injection. Es una enfermedad infecciosa causada por la bacteria Mycobacterium leprae. Now customize the name of a clipboard to store your clips. They are slender, slightly curved or straight rods, measuring 1-8 µm x 0.2-0.5 µm, with considerable variation in size. Difference between Lepromatous Leprosy and Tuberculoid Leprosy 7. Depending on chemotherapy and alterations in resistance of the host, this clinical form may shift to any of the two extreme types. ◆◆◆ https://url.cn/5MYrgAB, Mycobacterium Leprae Con Nuevas Diapositivas, leprosy disease ppt Represented bynirjesh kumar mgip lucknow, No public clipboards found for this slide, Center for Molecular Dynamics - Nepal (CMDN). The distribution of new leprosy cases by country among 136 countries that reported to WHO in 2015. The decision if an infection requires treatment can only be made when the same pathogen is detected in different samples from one patient. If you wish to opt out, please close your SlideShare account. Therapy always depends on the respective species and its resistances to antibiotics. A high degree of innate immunity exists in man for this disease, but only few contacts develop clinical diseases. The living bacilli stain uniformly as a strong rod; whereas dead bacilli are fragment and granular. Name the types of nitrogenous bases present in the RNA. CMLT 2nd year. Corneal ulcer may occur due to damage of Vth and Vllth cranial nerves, foot drop in lateral popliteal nerve damage; loss of digits due to absorption of phalanges from base or due to osteomyelitis resulting from trauma to the insensitive area followed by secondary bacterial infection. Ridley and Jopling’s Classification 6. Lepromatous leprosy is more infectious than other types. In general, NTM are less pathogenic. In this type, the lesions clinically resemble tuberculoid leprosy, but bacteriologically and immunologically resemble lepromatous type. Prognosis of Leprosy: If the test is positive, the prognosis is better, if negative reaction converts into positive during treatment, it shows an improvement by therapy. In general, leprosy is curable. Despite their close genetic similarity, these organisms differ considerably with regard to epidemiology, pathogenicity and their host spectrum. What are the different sources of air pollution? Lepromatous type may develop in those with deficient cell mediated immunity. Transmission of Leprosy occurs in children exposed to heavy shedders of bacilli for long period. The lepromin test can detect the hypersensitivity in a leper. M. leprae cannot be grown on artificial media and tissue culture which are still under controversy. What are the general characters of pteridophytes? Eleven countries reported between 1000 and 10,000 cases: from Africa, the Democratic Republic of Congo, Ethiopia, Madagascar, Mozambique, Nigeria and United Republic of Tanzania; from Southeast Asia, Bangladesh, Myanmar, Nepal and Sri Lanka; and from Western Pacific, the Philippines. Mycobacterium Leprae Dr.T.V.Rao MD Dr.T.V.Rao MD 1 2. Your doctor will follow up with you over time and perform periodic skin examinations to see if you develop the disease. Due to their special staining characteristics under the microscope, which is mediated by mycolic acid in the cell wall, they are called acid-fast. On the basis of Lepromin test, Leprosy can be classified into: (a) Lepromatous leprosy, if this test is negative; (c) Borderline and indeterminate leprosy, if lepromin test is either negative or weakly positive. infection can lead to damage of the nerves, respiratory tract, skin, and eyes. M. abscessus, M. chelonae). Assessment of resistance to leprosy is preferable for field workers. Trisaccharide phenyl propionate Bovine serum Albumen (NTPBSA) has a stable hydrophilic substance that exhibits stronger sero reactivity than the natural PGL I antigen used to detect anti-PGL I antibodies. Content Guidelines 2. Esta enfermedad provoca úlceras cutáneas, daño neurológico y debilidad muscular que empeora con el tiempo. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Culture and resistance testing is only successful in animal models and takes about one year. The remaining 10,286 new cases (5%) were reported by 92 countries. CDC twenty four seven. After some google searching, I found this service ⇒ www.HelpWriting.net ⇐ who helped me write my research paper. Smear made from the scraping of skin, ear lobes, patches, nodules etc. India reported 127,326 new cases, accounting for 60% of the global new leprosy cases; Brazil, reported 26,395 new cases, representing 13% of the global new cases; and Indonesia reported 17,202 new cases, 8% of the global case load. Group III: non-chromogen (strains do not produce pigments), slow-growing NTM (e.g. The M. avium complex (MAC) comprises the species M. avium and M. intracellulare that range among the most important and most frequent pathogenic NTM. Hansen’s disease (also known as leprosy) is an infection caused by bacteria called Mycobacterium leprae. Yeast: Origin, Reproduction, Life Cycle and Growth Requirements | Industrial Microbiology, How is Bread Made Step by Step? bovis and M. bovis subsp. The pathogens are transmitted via droplet infection through the air by coughing or sneezing. According to the WHO, each year more than nine million people are newly infected with TB and about two million die from it. What is the reserve food material in red algae? file_external, World Health OrganizationExternal The positive reaction is an indication of resistance to leprosy. Before sharing your knowledge on this site, please read the following pages: 1. What is Leprosy?• It is a disease of Historical importamce• Worlds oldest recorded disease• Stigmatized disease• Gerhard Henrick Armauer Hansen Dr.T.V.Rao MD 3 4. They should be lepromin positive. Therefore, March 24th is now known to be World Tuberculosis Day, initiated by the World Health Organization (WHO). Nasal secretions and discharges from nodular lesions are infectious materials for family contacts by inhalation and through the skin. This is a question and answer forum for students, teachers and general visitors for exchanging articles, answers and notes. Leprosy is diagnosed according to the clinical symptoms and by laboratory diagnostics. The skin lesions are few and consist of non-elevated hypo- or hyper- pigmented macular anaesthetic patches on the face, trunks, and limbs. If you continue browsing the site, you agree to the use of cookies on this website. ✤✤✤ http://tinyurl.com/y4p92al9. M. scrofulaceum, M. gordonae) They can be cultivated in experimental animals: (3) Monkey of West Africa or chimpanzee which were found to suffer from natural disease (Leprosy). Privacy Policy3. Biology, Microbiology, Systematic Bacteriology, Human Disease, Leprosy, Mycobacterium Leprae. Nevertheless they can become carriers and infect someone else. This test is negative in lepromatous leprosy and is positive in tuberculoid leprosy. I do no use writing service very often, only when I really have problems. Leprosy is endemic and widespread in the underdeveloped countries—mainly Asia and Africa. Here's the link to this awesome free video about how to cure gout in 7 days or less – 100% naturally! Standard Serological Test (STS) gives false positive reaction in lepromatous leprosy. Even though every organ can be affected, the disease is manifested as pulmonary tuberculosis in 80% of the patients. Lepromin test is positive due to high degree of CMI. That’s because more than 95% of all people have natural immunity to the disease. The transmission of the disease is mostly by prolonged contact with infective patients. Normal habitat • M. leprae is probably the only pathogenic bacteria that has not yet been cultivated in-vitro. Leprosy is a chronic infectious disease that is caused by Mycobacterium leprae. Diagnostics of NTM is often difficult. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Learn more. 1. Leprosy is a chronic progressive disease of man. In this type, there is a mild transient tissue lesion, resembling maculo-anaesthetic patches, due to an early unstable tissue reaction. Antigenic Structure 4. Las muestras de biopsia deben obtenerse del frente de avance de la lesión tuberculoide o, en la lepra lepromatosa, de los nódulos o las placas. You will be subject to the destination website's privacy policy when you follow the link. Similar trial in children in Myanmar (Burma) claimed 82% protection where lepromatous leprosy is prevented. Visible lesions are due to infiltration of M. leprae into skin and cutaneous nerve. Anti-PGL- I antibody titres are very high in new untreated lepromatous cases as compared to old treated patients. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Various serological tests were aimed at the detection of anti-phenolic glycolipid I (anti-PGL I) antibodies. Our mission is to provide an online platform to help students to share notes in Biology. TOS4. ar "-//W3C//DTD HTML 4.01 Transitional//EN" Countries that reported more than 1,000 new cases of Hansen’s disease to WHO between 2011 and 2015 are: You may also be at risk if you are in prolonged close contact with people who have untreated Hansen’s disease. In 1882 the German physician and microbiologist Robert Koch discovered M. tuberculosis to be the causative pathogen of phthisis. The lesion heals spontaneously in many persons and in others it may progress to tuberculoid or lepromatous type. This lipid has been extracted from M. leprae and a carbohydrate antigenic determinant has also been synthesised from its carbohydrate and used to prepare a monoclonal antibody. International bacteriological index is from 1 to 6+: It is the percentage of uniformly stained bacilli in a lesion out of the total bacteria present in the lesion and it can assess the prognosis and response of the disease to the drug. Nevertheless, if the disease is diagnosed too late, nerve tracts can be irreversibly damaged. can be stained by modified Z-N method using 5% sulphuric acid and examined. Later WHO recommended multi-drug therapy (MDT) for all types of Leprosy by the use of rimfapicin, dapsone and clofazimine (Table 41.3). Govind P. Sah, M.Sc. ADVERTISEMENTS: This antibody can be used to detect and identify … • The bacteria may be inhaled or possibly … It is a generalized form of Leprosy and is encountered in individuals where the host resistance is low. Leprosy is a chronic infectious disease that is caused by Mycobacterium leprae. Es una enfermedad infecciosa causada por la bacteria Mycobacterium leprae. If they have not been treated, you could get the bacteria that cause Hansen’s disease. The risk of infection is increased by bad hygiene conditions and in densely populated areas. Con el objeto de alcanzar la curación, se puede utilizar un esquema terapéutico que contenga fármacos activos contra ambas especies de micobacterias. M. marinum is responsible for skin and soft tissue infections like aquarium granuloma. Esta enfermedad provoca úlceras cutáneas, daño neurológico y debilidad muscular que empeora con el tiempo. They are latex agglutination, Mycobacterium leprae Particle Agglutination (MLPA) test and ELISA. Mycobacterium Las pautas actuales de tratamiento de la MDR-TB pueden comportar un cierto número de fármacos como la levofloxacina y la clofazimina, que tienen también actividad contra el Mycobacterium leprae. Recent estimations suggest that one third of the world’s population is infected with tuberculosis. Hey, I'm only 18 and I thought I was going to have small boobs forever. Share Your PDF File As of this date, Scribd will manage your SlideShare account and any content you may have on SlideShare, and Scribd's General Terms of Use and Privacy Policy will apply. Their generation time in experimental animals is about 12-13 days. Antigenic Structure of Mycobacterium Leprae: 4. I'm so pleased and I'm getting a lot more attention from boys now! Lecture notes, Medical Microbiology CMLT 2nd year 2. As of this date, Scribd will manage your SlideShare account and any content you may have on SlideShare, and Scribd's General Terms of Use and Privacy Policy will apply. They belong to the RGM group if under ideal conditions they grow within less than seven days and to the SGM group if they need more than seven days to grow. M. bovis is the major cause of bovine tuberculosis. Group IV: rapid-growing NTM (e.g. On very rare occasions these pathogens were found to cause TB in humans. To become infected one must be in close contact with a patient. The team of writers operates very quickly. Hello! For therapeutic purpose, they classified Leprosy into 5 groups: According to World Health Organisation (WHO), Leprosy is divided into two groups: Paucibacillary which includes all tuberculoid types and multi-bacillary which includes all lepromatous types and some borderline type. If you wish to opt out, please close your SlideShare account. What are the general characters of bryophytes? The indeterminate form occupies a position between the two extreme forms (tuberculoid and lepromatous type). Clinically there are four types of Leprosy: Delayed type hypersensitivity plays a great role in determining the response of the host to infection and production of clinical type: Tuberculoid type of Leprosy is very common in patients with high degree of Cell-Mediated Immunity (CMI); whereas in lepromatous type leprosy the cell-mediated type immunity is either absent on deficient. M. canettii was mainly isolated from small rodents, whereas M. pinnipedii was detected in seals. Blood of lepromatous leprosy patients may have adequate number of bacilli which may be transmitted by blood-sucking insects. Lepra bacilli prefer lower temperature, therefore they localize in superficial cooler tissue, i.e. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. The incubation period is 3-15 years. Leprosy• Vedas• Bible• Fear and Social outcasts• Hansen 1868 - Identifies First microorganism• Least understood and not cultured in artificial medium Dr.T.V.Rao MD 2 3. When 0.1 ml of lepromin (containing 40 millions dead lepra bacilli) is injected intradermally to an individual, it produces at the site of injection an area of nodular infiltration in skin which reaches its maximum size in 3 to 5 weeks. The relationship of this natural disease with human infection is yet to be established. This antibody can be used to detect and identify M. leprae in tissues. See our User Agreement and Privacy Policy. Heal Vitiligo In 21 Days? In the U.S., Hansen’s disease is rare. Complications of Therapy and Other Details. As the pathogens infect cells of the immune system, so-called macrophages, especially infants and immunocompromised persons are at risk. It was discovered in 1873 by the Norwegian physician Gerhard Armauer Hansen, who was searching for the bacteria in the skin nodules of patients with leprosy. You cannot get leprosy from a casual contact with a person who has Hansen’s disease like: Hansen’s disease is also not passed on from a mother to her unborn baby during pregnancy and it is also not spread through sexual contact. Therefore, reliable diagnostics provide the basis for successful therapy. Just like M. kansasii, M. malmoense and M. xenopi they mostly cause pulmonary infections. The fragmented, granular bacteria are seen in smears from skin, mucous membrane scrapings of nasal septum of patients under treatment. M. bovis can be divided into two subspecies, M. bovis subsp. The granulation tissue with a large aggregation of vacuolated mononuclear cells containing lepra bacilli is a characteristic feature of lepromatous to repeated trauma and may get secondary infected resulting to distortion and mutilation of extremities. caprae. See our Privacy Policy and User Agreement for details. If you continue browsing the site, you agree to the use of cookies on this website. TB can be found all around the world and other than HIV/AIDS and malaria it is one of the most frequent infectious diseases. Most leprosy infections are without pathological findings and heal spontaneously. Leprosy, also known as hansen's disease (hd), is a long term infection by the bacteria mycobacterium leprae or mycobacterium lepromatosis. Based on this discovery, diagnosis of the disease could considerably be improved. Besides, they also contain a unique O-diphenoloxidase, an enzyme characteristic of Lepra bacilli from armadillo or human tissue. Collectively, these countries reported 19,069 new cases, 14% of all new cases globally. Mycobacterium leprae 1. In contrast, in many developing countries the disease is still a serious health problem. Clipping is a handy way to collect important slides you want to go back to later. Vitiligo Miracle Video - Heal Vitiligo In 7 Days ➜➜➜ https://bit.ly/3kTNHDZ, 1 Weird Trick To Easily Cure Vitiligo For Good In As Little As 7 Days - Guaranteed! CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Disclaimer Copyright, Share Your Knowledge India reported 127,326 new cases, accounting for 60% of the global new leprosy cases; Brazil, reported 26,395 new cases, representing 13% of the global new cases; and Indonesia reported 17,202 new cases, 8% of the global case load. It can be transmitted to humans by the consumption of unpasteurised milk or in rare cases via inhalation of dust in barns. Slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Large number of M. leprae present in skin lesions and in mucosa of nose, mouth and upper respiratory tract are shed in sweat, nasal and oral secretions. 3. No other countries reported >10,000 new cases. M. leprae contain carbohydrate and a characteristic surface lipid, phenolic glyco lipid I (PGL I). We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. They can be detected in soil, ground and drinking water as well as in food like pasteurized milk or cheese. Group II: skotochromogen (strains producing pigments even in the dark), slow-growing NTM (e.g. skin, ears, nasal mucosa and peripheral nerves, lungs, liver, testes, eyes and bones are also affected. Lepromatous leprosy patients give false positive reaction in standard serological tests for syphilis. If you continue browsing the site, you agree to the use of cookies on this website. Difference between Lepromatous Leprosy and Tuberculoid Leprosy: Antigenic Structure of Mycobacterium Leprae, Clinical Features of Mycobacterium Leprae, Ridley and Jopling’s Classification of Mycobacterium Leprae, Difference between Lepromatous Leprosy and Tuberculoid Leprosy, The best answers are voted up and rise to the top. Overall, the risk of getting Hansen’s disease for any adult around the world is very low. Qué es. Due to its slow proliferation rate with a generation time of 10 to 14 days, the incubation period can last several months or even years. (With Methods)| Industrial Microbiology, How is Cheese Made Step by Step: Principles, Production and Process, Enzyme Production and Purification: Extraction & Separation Methods | Industrial Microbiology, Fermentation of Olives: Process, Control, Problems, Abnormalities and Developments. [1] Es intracelular y pleomórfica, [2] aunque usualmente tiene forma de bastón, es ácido-alcohol resistente, aerobia y sólo remotamente emparentada con Mycobacterium tuberculosis. I have always found it hard to meet the requirements of being a student. Lecture notes, Medical Microbiology Though they are Gram-positive, they cannot be easily stained by Gram stain as they contain wax like substance (mycolic acid) in their cell wall; but they can be stained by Z-N method by substituting 5% sulphuric acid (H2SO4) for 20% which is used for decolourisation after staining with steamed carbol fuchsin. Injection of ground tissue from the lesion into foot pad of mouse may produce typical granuloma in six months. More Info.. ➤➤ http://tinyurl.com/y4p92al9. The bacteria attack the nerves, which can become swollen under the skin. Scribd will begin operating the SlideShare business on December 1, 2020 2. Share Your PPT File. Mycobacterium leprae y M. lepromatosis no proliferan en los medios de cultivo artificiales. B. Histological Examination of Skin Nerve Biopsy: When lepra bacilli cannot be demonstrated by direct smear the histological examination of the biopsy material can be undertaken to confirm tuberculoid leprosy. Recent vaccine (LEPROVAC) stimulates immune system to kill M. leprae and accelerates bacterial clearance which enables the patient to be cured under experimentation. Due to its slow proliferation rate with a generation time of 10 to 14 days, the incubation period can last several months or even years. I do no use writing service very often, only when I really have problems. In the southern United States, some armadillos are naturally infected with the bacteria that cause Hansen’s disease in people and it may be possible that they can spread it to people. Welcome to BiologyDiscussion! Though it is useful to assess the prognosis of leprosy, it has a limited diagnostic value. Scribd will begin operating the SlideShare business on December 1, 2020 We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. Nevertheless, the WHO still recommends BCG vaccination for children under one year of age in high risk countries. Typically patients got in contact with an aquarium. While the latter is sensitive to pyrazinamide (PZA), M. bovis subsp. The deformities of hands and feet are due to thickened, hard, tender nerve trunks. In MLPA test, gelatin particles coated with natural. If you had a contact with an armadillo and are worried about getting Hansen’s disease, talk to your healthcare provider. This is either characteristic of tuberculoid nor lepromatous type. What are the modifications that are observed in birds that help them fly? The antibody titres decrease following effective chemotherapy. It is not known exactly how Hansen’s disease spreads between people. For general health reasons, avoid contact with armadillos whenever possible. Similar nodular lesion of 3-5 mm in diameter appears in 3 to 5 weeks after injection. Scientists currently think it may happen when a person with Hansen’s disease coughs or sneezes, and a healthy person breathes in the droplets containing the bacteria. Cultivation of Mycobacterium Leprae 3. … In the southern United States, some armadillos are naturally infected with the bacteria that cause Hansen's disease. But this one, I like best of all. As leprosy can be treated it is nearly extinct in countries that provide good health care. The distribution of new leprosy cases by country among 136 countries that reported to WHO in 2015. 1. This is also the reason for the hardiness of mycobacteria. Effective treatment with antituberculotics. Answer Now and help others. There is no standard therapy for the treatment of NTM infections. Mycobacterium leprae es una especie bacteriana, también conocida con el nombre de bacilo de Hansen, es la bacteria que causa la lepra o «enfermedad de Hansen». Lepra no es muy contagiosa y tiene un largo período de incubación (tiempo antes de que aparezcan los síntomas), lo cual dificulta saber dónde y cuándo alguien contrajo la enfermedad. • M. leprae reaches the environment from the nose and upper respiratory tract of persons with multibacillary leprosy. Nowadays this infection is quite rare in central Europe as the cattle population is largely free of tuberculosis. Tuberculoid type develops in patients with hypersensitivity. Around the world, as many as 2 million people are permanently disabled as a result of Hansen’s disease. People who suffer from leprosy are also facing social problems that go hand in hand with the disease. Morphology of Mycobacterium Leprae 2. Looks like you’ve clipped this slide to already. M. tuberculosis is considered to be the main cause of TB in humans. Clipping is a handy way to collect important slides you want to go back to later. This complex comprises the following species: These species are, with the exception of M. bovis BCG, considered to cause tuberculosis (TB) in humans and animals. M. avium, M. haemophilum) Tuberculosis infections usually arise from patients, who suffer from active and thus infectious pulmonary tuberculosis. Skin scraping for M. leprae examination and lepromin test are either negative or positive. However, as soon as patients start treatment, they are no longer able to spread the disease. Schwann nerve cell is the target for these bacilli; thereby the nerve is damaged and ultimate manifestations of Leprosy are anesthesia and muscle paralysis. Man is the main source of infection. La lepra o enfermedad de Hansen es una enfermedad infecciosa crónica producida por la bacteria Mycobacterium Leprae (bacilo ácido-alcohol resistente) que afecta, especialmente, al sistema nervioso periférico, la piel, la mucosa de las vías respiratorias superiores y los ojos. There may be suddenly acute exacerbation, testicular atrophy, necrosis of bone and cartilage, loss of upper incisor teeth, diffuse thickening of the face. A heterogeneous group of strains that can mainly be found in Africa and which exclusively causes TB in humans, is called M. africanum.
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