Abstract
The aim of this study was to investigate sensitivity disorders in the oral cavity related to the presence of Mycobacterium leprae in the saliva of treatment-naïve patients with leprosy in the state of Amazonas, Brazil. A cross-sectional study was conducted involving 45 subjects with leprosy. The subjects were interviewed to evaluate the sensitivity of the oral cavity. For the detection of M. leprae, saliva and slit-skin smear samples were collected. The samples were analysed using a bacteriological index (BI) protocol and the real-time quantitative polymerase chain reaction (qPCR). The results indicated that 15 of the 45 (33.3%) subjects with leprosy showed decreased oral sensitivity, which confirmed the importance of the oral cavity sensitivity evaluation. There was not a direct relationship between the presence of M. leprae in saliva and changes in oral sensitivity. Positive saliva qPCR results from six (31.6%) of 19 paucibacillary (PB) patients suggested the possibility of a new site for sample collection. Positive results using these diagnostic techniques (BI, slit-skin smear and saliva qPCR) increased to 55.5%, thus opening the possibility of combining these different techniques to increase the rate of positive diagnoses, especially in PB patients.
Highlights
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which slowly and insidiously affects the skin, peripheral nerves and mucous membranes (Margarido & Rivitti 2005)
In 2011, 33,955 new cases of leprosy were detected in Brazil (WHO 2012), 586 of which were in the state of Amazonas (AM) (FUAM 2011)
One of the key results of this study is that patients with leprosy were significantly more likely to have altered thermal sensitivity of the oral cavity than the control group
Summary
Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which slowly and insidiously affects the skin, peripheral nerves and mucous membranes (Margarido & Rivitti 2005). This disease can lead to deformity and disability, with serious social implications. The cranial nerve most affected by leprosy is the trigeminal nerve (V pair), which is responsible for tactile and thermal sensitivity in the face, the anterior two-thirds of the tongue and the hard and soft palates. Trigeminal nerve impairment in subjects with leprosy has been detected in a study by Reichart et al (1982), who noted hypoesthesia and anaesthesia in facial areas innervated by the trigeminal nerve in 29 out of 43 subjects
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