Evaluation of Fluorescent Staining for Diagnosis of Leprosy and its Impact on Grading of the Disease: Comparison with Conventional Staining
Introduction: Leprosy is a chronic infectious disease caused by Mycobacterium leprae (M. leprae). Histopathological examination of skin lesion is the gold standard for diagnosis. We evaluated the possible role of fluorescent microscopy in this direction which is increasingly used for rapid screen...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-10-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/8739/22470_CE[Ra1]_F(GH)_PF1(T_Vasu)_PFA(P)_PF2(P_PR).pdf |
| Summary: | Introduction: Leprosy is a chronic infectious disease caused by
Mycobacterium leprae (M. leprae). Histopathological examination of skin lesion is the gold standard for diagnosis. We
evaluated the possible role of fluorescent microscopy in this
direction which is increasingly used for rapid screening.
Aim: To compare the efficacy of auramine rhodamine stain with
Ziehl-Neelsen and modified Fite-faraco staining in diagnosing
M. leprae in tissue sections.
Study Design: Experimental, cross-sectional and retrospective
study conducted for 4 years.
Methods and Materials: Skin biopsies of sixty clinically diagnosed leprosy patients were stained by Ziehl-Neelsen, FiteFaraco and fluorescent stain. The presence of the bacilli and the
bacillary index was scored for each case. The bacillary index by
each staining methods were compared.
Statistical Analysis: SPSS v 17 (IBM, New York) used for data
analysis. Chi-Square test was used to calculate significance
between differences. The p-value of <0.05 was considered as
statistically significant. Pearson Correlation (r-value determined)
was also used for comparison between groups.
Results: Sensitivity of fluorescent stain for indeterminate and
borderline tuberculoid leprosies were 100% each. Positivity
rates and mean bacteriological index with fluorescent stain
was higher (43.3 and 11.5 respectively) as compared to that of
Ziehl- Neelsen and Fite-faraco when the bacillary load was less
(bacillary index < 3). There was significant correlation between
the three staining types at higher bacillary load. There was a
higher mean bacillary index with fluorescent stain as well as
detection of an additional multibacillary case.
Conclusion: Fluorescent method is more sensitive than modified
fite-faraco method in detecting lepra bacilli in tissue sections
especially in cases with bacillary index less than three. With
its higher sensitivity, paucibacillary cases could be upgraded to
multibacillary thus affecting treatement decisions. |
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| ISSN: | 2249-782X 0973-709X |