Wednesday, January 20, 2010

TB-like bacteria that cause leprosy, AND read the Bible with some skepticism.

Here's the skinny on nontuberculous mycobacterium. Mycobacterium is a genus of bacteria. Remember, in a family of bacteria there is the genus, Mycobacterium and the species, like tuberculosis, leprosy, and about 130 other species of bacteria that cause lung disease, skin disease and a bunch of other problems. These other species don't get the press that tuberculosis gets.

Nontuberculous mycobacterium share some of the structure of tuberculosis but they have never been known to be transmitted from person to person like TB. I think that is why they fly under the radar.

The classic findings of these bacteria are mycolic acid in their cell wall and a similar structure in something called 16s rRNA. Within this 16s rRNA there are subtle differences which seem to give the different genus' of mycobacterium their unique fingerprint, but this might be getting a little technical.

The most common lung disease from nontuberculous mycobacterium is caused by MAC, or mycobacterium avium intracellulare. It is commonly found in those that work with soil like construction workers and farmers since it is most prevalent in the soil. It is also common, for some unknown reason, in older women who are skinny. We are finding out that cholesterol and and the "fat" hormone leptin may play a role in fighting mycobacterium infection. These are the only diseases that may let you feel good about being obese with a high cholesterol because the immune system may work better against mycobacterium if you have extra weight and higher cholesterol. There are many other reasons to not be fat with a high cholesterol though so I wouldn't go pigging out on McDonalds' just yet.

Recently the New York Times and other papers reported the work of a Colorado State scientist, Norman Pace, who swabs things like subways, clothes and shower heads and found evidence of this bacteria to be ubiquitous. In fact he found that these bacteria form a film that allow them to survive in great numbers in shower heads. There have also been case reports of women having lung infection from isolates found to be from their showers. Hot tubs seem to be a source as well since the chlorine kills other bacteria but not mycobacterium. Infection is rare though so don't go selling your hot tub in a garage sale and if showers are your bag, and you're otherwise healthy, don't stop washing since your social well-being may be at risk more than your health.

Leprosy is caused by a mycobacterium that grows best in the 9 band armadillo, perhaps this accounts for reports of leprosy in Louisiana. But it is most common in India, the continent of Africa, and Brazil. It is a neuropathic bacteria that also causes depigmentation of the skin. Usually patients present with anesthetic patches on their skin and sometimes lumps. The immune system seems to have a difficult time with leprosy so antibiotic therapy is sometimes required for up to ten years. Antibiotic therapy for TB is usually 9 months, for bronchitis, 10 days.

The Bible references leprosy a lot. But recently scientists and Bible scholars have been noting these references with some skepticism since diagnostic skills were not as astute in Christ's time. After the Bible scholars such as Hippocrates, Herodotus and Galen have referenced leprosy. A common theme seems to suggest that these patients were "white as snow" and they comment on plaques of the skin and sometimes growths on the limbs. Many other disease have been suggested by modern science that would account for these reports from the Bible and Greeks such as: vitiligo(immune mediated depigmentation of the skin not caused by infection), psoriasis, elephantiasis(caused by a parasite), ringworm(fungus), elephant man's disease(neurofibromatosis) and other skin infections like those caused by Staph or Strep. It is commonly noted that the clothes and homes of lepers were "moldy" or the equivalent in our modern speak. Often the clothes and homes of these people were burned needlessly as a consequence.

So if you have boil on your skin don't let anyone burn your house down.

That's it for now.

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