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Two methods of demonstrating leprosy bacilli in smears

K Harada, T Kasai

    International Journal of Leprosy and Other Mycobacterial Diseases : Official Organ of the International Leprosy Association
    |April 1, 1978
    PubMed
    Summary

    A new staining method using periodic acid-carbol pararosaniline enhances detection of leprosy bacilli in skin smears, revealing more bacteria than traditional carbol fuchsin staining, even in long-treated patients.

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    Area of Science:

    • Microbiology
    • Dermatology
    • Infectious Diseases

    Background:

    • Leprosy diagnosis relies on identifying Mycobacterium leprae in skin smears.
    • Traditional carbol fuchsin staining may miss bacilli that have lost acid-fastness due to treatment.
    • Chemotherapy can alter bacillary morphology, potentially affecting diagnostic accuracy.

    Purpose of the Study:

    • To compare the efficacy of periodic acid-carbol pararosaniline staining with carbol fuchsin for detecting leprosy bacilli.
    • To investigate the presence of chromophobic leprosy bacilli in treated patients.
    • To assess the implications of altered bacillary staining for leprosy relapse.

    Main Methods:

    • Skin smears from 200 long-treated leprosy patients (tuberculoid, borderline, lepromatous) were stained using two methods: carbol fuchsin with acetic acid differentiation and periodic acid-carbol pararosaniline.
    • Bacillary Index (BI) and Morphological Index (MI) were determined for each smear.
    • Comparison of bacillary detection rates between the two staining techniques.

    Main Results:

    • Periodic acid-carbol pararosaniline staining yielded significantly higher BI and MI determinations compared to carbol fuchsin.
    • Leprosy bacilli were detected in 69 of 96 smears where carbol fuchsin staining showed no bacilli.
    • The study suggests that antileprosy drugs can induce a chromophobic state in leprosy bacilli, which can be reversed by periodic acid pretreatment.

    Conclusions:

    • Periodic acid-carbol pararosaniline is a more sensitive method for detecting leprosy bacilli, especially in treated patients.
    • Chromophobic leprosy bacilli can persist in lesions after prolonged chemotherapy and may represent a source of relapse.
    • This finding has implications for monitoring treatment response and understanding leprosy epidemiology.

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