(LML) Alternative MDT drugs and treatment duration

Leprosy Mailing List – June 6,  2015

Ref.:  (LML) Alternative MDT drugs and treatment duration

From:   Teem-Wing Yip, Alice Springs, Northern Territory, Australia

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Dear Sir,

Thanks for posting my recent correspondence.

Prof. Indropo Agusni wanted clarification on a few things.

The patient is actually from the Philippines, not from Indonesia.

The morphological index was requested, so I am including the results of all the smears below.

Before treatment, 2013
Left ear:
Microscopy:      Acid fast bacilli seen.
   Bacillary index: 100-1000 bacilli in an average field.
   Morphological index  3     51-75% Normal     49-25% Fragmented
    Globi           Moderate numbers of globi seen.
Right ear:
   Microscopy:      Acid fast bacilli seen.
   Bacillary index: 100-1000 bacilli in an average field.
   Morphological index  4     76-100% Normal     24-0% Fragmented
    Globi           Occasional globus seen.
 
Second skin smear 2014 (after 1 year of  treatment).
Left ear:
Microscopy:      Acid fast bacilli seen.
      Bacillary index: 10-100 bacilli in an average field.
      Morphological index  1     0-25% Normal     100-75% Fragmented
       Globi           Occasional globus seen.
Right ear:
      Microscopy:      Acid fast bacilli seen.
      Bacillary index: 10-100 bacilli in an average field.
      Morphological index  1     0-25% Normal     100-75% Fragmented
       Globi           Occasional globus seen.
 
Third skin smear 2015 (after 2 years of treatment).
 LEFT EAR
      Acid fast bacilli seen
      Bacillary index = 4
      Morphological index = 1
      95% fragmented AFB
      5% normal AFB
      Occasional globus seen
RIGHT EAR
      Acid fast bacilli seen
      Bacillary index = 4
      Morphological index = 1
      95% fragmented AFB
      5% normal AFB
      Moderate globi seen

I hope this additional information is helpful in giving me appropriate advice for this patient.

Many thanks in advance for whatever advice might be offered regarding whether this patient can safely cease treatment after two years, or whether there is any benefit in continuing.

Yours sincerely,
Dr. Teem-Wing Yip
Alice Springs, Northern Territory, Australia

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

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