いわゆる菌陰性者における癩菌の検出とその手技の検討

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  • Detection of M. leprae in the skin lesions of the so-called negative cases. Scrutinization of concentration methods
  • イワユル キン インセイシャ ニ オケル ライキン ノ ケンシュツ ト ソノ シュギ ノ ケントウ

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Detection of M. leprae in 168 skin samples removed by trepanation from 58 patients negative for bacilli in repeated examinations of 3 to 8 times in the periods ranging from 1/2 to 2 years was performed. In addition, 6 cases showing occasionally positive, and 17 cases showing 2+ to 3+ positive for bacilli were examined similarly. These skin pieces were smeared directly or after trituration and grinding (40 samples of 27 cases) on slides and examined. For the purpose of concentration of bacilli in the tissue, two techniques were employed, NaOH-(with and without acetic acid treatment) and chloroform-methods. The results obtained were summarized as follows : <br>1) The trepan-snip method seemed to be slightly superior to the routine slit method so far as the 168 samples concerned. However, 3 out of the skin samples showing positive for bacilli, very few in number, by slit method, gave negative results. <br>2) Smearing preparation after grinding the skin piece in a mortar did not work only unfavorably for search of M. leprae, but also made it difficult presumably because of increase in masking effect of tissue debris on bacillary bodies which would be gradually losing their acid-fastness. <br>3) Concentration procedure with NaOH chloroform was unlikely serviceable to the purpose of detecting M. leprae in the skin smaples of very small amount with scanty bacilli. <br>4) From these results, it can be safely stated that the routine snip or scraping method is a fairly good means for detection of M. leprae. The method is quite simple, practical and suitable for repeated examinations. In addition, the yield is not necessarily inferior in efficiency to snip method, if care is taken for selection of the site to be examined, and for preparation of films after rendering the site bloodless by pressure. <br>5) Varied changes in morphological and tinctorial properties of M. leprae were observed; viz., granular form (5 cases), shortening of bacillary body (1), purplish red (3) or pale bluish staining (1), etc. The meaning of these changes remains to be solved by further research. <br>6) The instruments to be used should be kept quite sanitary. Cleaning of the knife, and other instruments, mortar and pestle, etc. in a boiling NaHCO3-solution is very simple and satisfiable for washing out adhering acid-fast germs to them.

収録刊行物

  • レプラ

    レプラ 35 (4), 231-236, 1966

    日本ハンセン病学会

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