Mycobacterium leprae

Clinical Presentation

• Incubation period of 3-5 years (with wide range)
• Classic presentation is anaesthetic hypopigmented skin lesion with thickened nerves
• Clinical spectrum from tuberculoid, paucibacillary disease to lepromatous, multibacillary disease

Management

Disease	Treatment
Paucibacillary	6 months of rifampin, dapsone, and clofazimine
Multibacillary	12 months of rifampin, dapsone, and clofazimine
Rifampin resistance	6 months of at least two second-line drugs with clofazimine, followed by 18 months of one second-line drug with clofazimine
Quinolone resistance	As for rifampin resistance, but without a fluoroquinolone

Second-line antibiotics

• Clarithromycin
• Minocycline
• Fluoroquinolones