Granulomatous diseases: Disease: Tuberculosis Leprosy Buruli ulcer MOTT diseases Actinomycosis Nocardiosis Etiology Mycobacterium M. leprae M. ulcerans M. kansasii Actinomyces israelii Nocardia asteroides tuberculosis M. scrofulaceum M. africanum M. avium- M. bovis intracellulare M. marinum Reservoir Humans (M. tuberculosis, HUMANS only Environment Environment HUMANS only Environment M. africanum*) (uncertain) Animals (M. bovis) Infects animals Transmission Air-borne route Air-borne route Uncertain: Air-borne NONE Air-borne route to humans Food-borne route Direct contact traumatic Traumatic inoculation endogenous infection Traumatic (M. bovis) inoculation, Habitat: oral cavity, inoculation insect bite? intestines, female genital tract Clinical Tuberculosis (TB): Leprosy=Hansen’s Disseminating Lung disease Abscesses in the skin Broncho-pulmonary picture pulmonary and/or disease skin ulcers Cervical lymphadenitis adjacent to mucosal surfaces (lung abscesses) extra-pulmonary Tuberculoid leprosy Disseminated (cervicofacial actinomycosis), Cutaneous infections (disseminated: kidneys, Lepromatous leprosy infection in the lungs (pulmonary) or such as: mycetoma, bones, spleen, meninges) Skin infections in the abdominal cavity lymphocutaneous (peritonitis, abscesses in infections, ulcerative appendix and ileocecal lesions, abscesses, regions) cellulitis; Dissemination: brain abscesses Distribution All over the world India, Brazil, Tropical disease All over the world All humans Tropical disease * Africa Indonesia, Africa (e.g. Africa, Asia, (e.g. India, Africa, South Australia, South America) America) Prophylaxis Live, attenuated vaccine None None None None None containing M. bovis strains Diagnosis Microscopy: sputum smear Microscopy: skin Microscopy Culture, identification, Microscopy (Gram staining), Microscopy (acid-fast staining), smears, skin biopsies (acid-fast PCR culture, identification (acid-fast staining), culture, identification, PCR (acid-fast staining; staining), culture, culture, Skin test detecting delayed histopathology) PCR, identification hypersensitivity (tuberculin Skin lepromin tests histopathology skin test) .