Bacillaemia in lepra reaction: its correlation with liver pathology

Thirty patients of lepromatous leprosy in a state of reaction (ENL) were studied for bacillaemia and a correlation was made with liver pathology. Buffy coat smears were examined in all, eliminating as far as possible the chances of contamination of blood by the skin bacilli. Thirteen out of thirty patients showed presence of acid fast bacilli (AFB) in the buffy coat smear. Hepatic involvement in the form of leprous granuloma was observed in all, of which 93.3% showed presence of AFB. It is concluded that during reaction the possibility of heightened bacillaemia is less likely and that the systemic spread of infection is not accentuated during the bouts of reaction.