{"id":476,"date":"2022-03-25T18:06:38","date_gmt":"2022-03-25T12:21:38","guid":{"rendered":"http:\/\/bacteriologynotes.com\/?p=311"},"modified":"2022-09-20T01:56:33","modified_gmt":"2022-09-19T20:11:33","slug":"pathogenesis-and-clinical-manifestations-of-mycobacterium-leprae","status":"publish","type":"post","link":"https:\/\/microbenotes.com\/pathogenesis-and-clinical-manifestations-of-mycobacterium-leprae\/","title":{"rendered":"Pathogenesis and Clinical Manifestations of Mycobacterium leprae"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_65 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title \" >Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #0a0a0a;color:#0a0a0a\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #0a0a0a;color:#0a0a0a\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/microbenotes.com\/pathogenesis-and-clinical-manifestations-of-mycobacterium-leprae\/#pathogenesis-of-mycobacterium-leprae\" title=\"Pathogenesis of Mycobacterium leprae \">Pathogenesis of Mycobacterium leprae <\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/microbenotes.com\/pathogenesis-and-clinical-manifestations-of-mycobacterium-leprae\/#clinical-manifestations-of-leprosy-caused-by-mycobacterium-leprae\" title=\"Clinical Manifestations of Leprosy caused by Mycobacterium leprae \">Clinical Manifestations of Leprosy caused by Mycobacterium leprae <\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"pathogenesis-of-mycobacterium-leprae\"><\/span><span style=\"color: #000000;\"><strong>Pathogenesis of <em>Mycobacterium leprae<\/em> <\/strong><\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><span style=\"color: #000000;\"><em>M. leprae\u00a0<\/em>is an acid-fast, gram-positive obligate intracellular bacillus that shows tropism for cells of the reticuloendothelial system and peripheral nervous system (notably Schwann cells).<\/span><\/li>\n<li><span style=\"color: #000000;\">Organisms may be acquired by the susceptible host usually through respiratory system or by way of skin to skin contact (between exudates of a leprosy patient\u2019s skin lesions and the abraded skin of another individual).<\/span><\/li>\n<li><span style=\"color: #000000;\">It has low pathogenecity, only a small proportion of infected people develop signs of the disease with incubation period varying from 6 months to 40 years or longer.<\/span><\/li>\n<li><span style=\"color: #000000;\">After entering the body, bacilli migrate towards the neural tissue and enter the Schwann cells.<\/span><\/li>\n<li><span style=\"color: #000000;\">Toll-like receptors (TLRs) also play important role in the pathogenesis of leprosy.<\/span><\/li>\n<li><span style=\"color: #000000;\">TLRs, such as TLR-1 and TLR-2, are found on the surface of Schwann cells, especially in patients with tuberculoid leprosy.<\/span><\/li>\n<li><span style=\"color: #000000;\"><em>M. leprae <\/em>activates this receptor on Schwann cells, which is suggested to be responsible for the activation of apoptosis genes and which enhances the onset of nerve damage seen in the mild disease.<\/span><\/li>\n<li><span style=\"color: #000000;\">Bacteria can also be found in, macrophages, muscle cells and endothelial cells of blood vessels.<\/span><\/li>\n<li><span style=\"color: #000000;\">After entering the Schwann cells \/macrophage; fate of the bacterium depends on the resistance of the infected individual towards the infecting organism.<\/span><\/li>\n<li><span style=\"color: #000000;\">Bacilli start multiplying slowly (about 12-14 days for one bacterium to divide into two) within the cells, get liberated from the destroyed cells and enter other unaffected cells.<\/span><\/li>\n<li><span style=\"color: #000000;\">Till this stage person remains free from signs and symptoms of leprosy.<\/span><\/li>\n<li><span style=\"color: #000000;\">As the bacilli multiply, bacterial load increases in the body and infection is recognized by the immunological system.<\/span><\/li>\n<li><span style=\"color: #000000;\">Lymphocytes and histiocytes (macrophages) invade the infected tissue.<\/span><\/li>\n<li><span style=\"color: #000000;\">At this stage clinical manifestation may appear as involvement of nerves with impairment of sensation and\/ or skin patch.<\/span><\/li>\n<li><span style=\"color: #000000;\">If it is not diagnosed and treated in the early stages, further progress of the diseases is determined by the strength of the patient\u2019s immune response.<\/span><\/li>\n<li><span style=\"color: #000000;\">Specific and effective cell mediated immunity (CMI) provides protection to a person against leprosy.<\/span><\/li>\n<li><span style=\"color: #000000;\">When specific CMI is effective in eliminating\/controlling the infection in the body, lesions heal spontaneously or it produces pauci-bacillary (PB) type of leprosy.<\/span><\/li>\n<li><span style=\"color: #000000;\">If CMI is deficient; the disease spreads uncontrolled and produces multi bacillary (MB) leprosy with multiple system involvement.<\/span><\/li>\n<li><span style=\"color: #000000;\">Blood stream may be invaded, with resulting foci in the liver, spleen, adrenals, testicles and bone marrow and excretion in the milk.<\/span><\/li>\n<li><span style=\"color: #000000;\">Lepromatous leprosy (multibacillary leprosy) is more infectious than other types and have poor prognosis.<\/span><\/li>\n<li><span style=\"color: #000000;\">In all forms of leprosy, <em>M. leprae<\/em> invade both sensory and motor nerves and destroy nerve fibers.<\/span><\/li>\n<li><span style=\"color: #000000;\">Sometimes, the immune response is abruptly altered, either following treatment or due to improvement of immunological status, which results in the inflammation of skin and\/ or nerves and even others tissue, called as leprosy reaction.<\/span><\/li>\n<\/ul>\n<figure id=\"attachment_314\" aria-describedby=\"caption-attachment-314\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-314\" src=\"https:\/\/microbenotes.com\/wp-content\/uploads\/2018\/02\/Pathogenesis-and-Clinical-Manifestations-of-Mycobacterium-leprae.jpg\" alt=\"Pathogenesis and Clinical Manifestations of Mycobacterium leprae\" width=\"650\" height=\"340\" \/><figcaption id=\"caption-attachment-314\" class=\"wp-caption-text\"><span style=\"color: #000000;\"><em><strong>Source: Epomedicine<\/strong><\/em><\/span><\/figcaption><\/figure>\n<ul>\n<li><span style=\"color: #000000;\">Though leprosy runs as a chronic disease, several allergic type of acute exacerbations occur throughout its course, called leprae reactions which are of two types:<\/span><\/li>\n<li><span style=\"color: #000000;\"><strong>Lepra reaction Type 1<\/strong><\/span>\n<ul>\n<li><span style=\"color: #000000;\">It is also called as reversal reaction and occurs in borderline cases (BT, BB, BL) who develop cell mediated immunity and consequently shifts towards tuberculoid part of spectrum.<\/span><\/li>\n<li><span style=\"color: #000000;\">Clinically there is erythema and swelling of the skin lesions which may undergo ulceration.<\/span><\/li>\n<li><span style=\"color: #000000;\">There is a predominant THl response with increased levels of IFN-\u03b3 and IL-2.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li><span style=\"color: #000000;\"><strong>Lepra Reaction Type-2<\/strong><\/span>\n<ul>\n<li><span style=\"color: #000000;\">It is developed mostly in lepromatous patients (LL or BL),undergoing chemotherapy.<\/span><\/li>\n<li><span style=\"color: #000000;\">The most common feature is crops of painful erythematous papules, which become nodular termed as Erythema Nodosum Leprosum (ENL).<\/span><\/li>\n<li><span style=\"color: #000000;\">Relapse is common and recurrent cases are more severe.<\/span><\/li>\n<li><span style=\"color: #000000;\">There is a predominant TH2 response with increased levels of IL-6 and IL-8.<\/span><\/li>\n<li><span style=\"color: #000000;\">Tumor necrosis factor-\u03b1 (TNF-\u03b1) plays a central role in the immunology of ENL.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-312\" src=\"https:\/\/microbenotes.com\/wp-content\/uploads\/2018\/02\/Pathogenesis-of-Mycobacterium-leprae.png\" alt=\"Pathogenesis of Mycobacterium leprae\" width=\"926\" height=\"308\" \/><\/span><\/p>\n<h2><span class=\"ez-toc-section\" id=\"clinical-manifestations-of-leprosy-caused-by-mycobacterium-leprae\"><\/span><span style=\"color: #000000;\"><strong>Clinical Manifestations of Leprosy caused by <em>Mycobacterium leprae<\/em> <\/strong><\/span><span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p><span style=\"color: #000000;\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-313\" src=\"https:\/\/microbenotes.com\/wp-content\/uploads\/2018\/02\/Clinical-Manifestations-of-Leprosy-caused-by-Mycobacterium-leprae.png\" alt=\"Clinical Manifestations of Leprosy caused by Mycobacterium leprae\" width=\"1200\" height=\"842\" \/><\/span><\/p>\n<p><span style=\"color: #000000;\"><strong>A. Tuberculoid leprosy <\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">The course is benign and non progressive, with a small number of macular skin lesions containing few bacilli (especially the nose, outer ears, and testicles), and in superficial nerve endings.<\/span><\/li>\n<li><span style=\"color: #000000;\">These are usually circular, or serpiginous, sharply demarcated and often hypopigmented (patch lighter in colour compared to surrounding skin).<\/span><\/li>\n<li><span style=\"color: #000000;\">These lesions may have raised and erythematous border with a dry scaly appearance in the center with complete anesthesia.<\/span><\/li>\n<li><span style=\"color: #000000;\">The skin lesions are commonly found on the face, limbs, buttocks, or elsewhere but are not found in the axilla, perineum, or scalp.<\/span><\/li>\n<li><span style=\"color: #000000;\">Neuritis leads to patches of anesthesia in the skin.<\/span><\/li>\n<li><span style=\"color: #000000;\">The organisms grow and cause thickening in nerve sheaths.<\/span><\/li>\n<li><span style=\"color: #000000;\">These thickened nerves can be felt through the skin, a characteristic of leprosy.<\/span><\/li>\n<li><span style=\"color: #000000;\">The ulnar, peroneal, and greater auricular nerves are involved, leading to tender, thickened nerves with subsequent loss of function.<\/span><\/li>\n<li><span style=\"color: #000000;\">Damage of the nerve can result in wrist drop or foot drop.<\/span><\/li>\n<li><span style=\"color: #000000;\">The lesions are heavily infiltrated by lymphocytes and giant and epithelioid cells, but caseation does not occur.<\/span><\/li>\n<li><span style=\"color: #000000;\">The patient mounts a strong cell-mediated immune response and develops delayed hypersensitivity, which can be shown by a skin test with lepromin, a tuberculin-like extract of lepromatous tissue.<\/span><\/li>\n<li><span style=\"color: #000000;\">There are few bacteria in the lesions also called as paucibacillary.<\/span><\/li>\n<li><span style=\"color: #000000;\">Patients with tuberculoid leprosy (also called paucibacillary Hansen disease) have a strong cellular immune reaction with many lymphocytes and granulomas present in the tissues and relatively few bacteria.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>B. Borderline tuberculoid leprosy<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Lesions in this form of leprosy are similar to those seen in the tuberculoid leprosy, but are smaller and more numerous.<\/span><\/li>\n<li><span style=\"color: #000000;\">Skin lesions are few, asymmetric, and with nearly complete anesthesia.<\/span><\/li>\n<li><span style=\"color: #000000;\">Peripheral nerves are thickened and involved asymmetrically.<\/span><\/li>\n<li><span style=\"color: #000000;\">This form of leprosy may remain at this stage or can regress to the tuberculoid form; or it can progress to lepromatous form.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>C. Mid-borderline leprosy<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Skin lesions in this type of leprosy consist of numerous unequally shaped plaques that are less well defined than in the tuberculoid types.<\/span><\/li>\n<li><span style=\"color: #000000;\">These skin lesions are distributed asymmetrically.<\/span><\/li>\n<li><span style=\"color: #000000;\">Anesthesia is moderate, and the disease can remain in this stage, can improve, or worsen to more disseminated form.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>D. Borderline lepromatous leprosy<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">Skin lesions are moderate to numerous.<\/span><\/li>\n<li><span style=\"color: #000000;\">They are slightly asymmetrical with slight or no anesthesia.<\/span><\/li>\n<li><span style=\"color: #000000;\">Peripheral nerves are enlarged moderately and symmetrical.<\/span><\/li>\n<li><span style=\"color: #000000;\">Like the other forms of borderline leprosy, the disease may remain in this stage, improve, or lead to lepromatous form.<\/span><\/li>\n<\/ul>\n<p><span style=\"color: #000000;\"><strong>E. Lepromatous leprosy<\/strong><\/span><\/p>\n<ul>\n<li><span style=\"color: #000000;\">The lepromatous leprosy is characterized by the presence of large number of acid fast bacilli in large clumps (globi) inside the macrophages (lepra cells).<\/span><\/li>\n<li><span style=\"color: #000000;\">The skin lesions include macules, nodules, plaques, or papules.<\/span><\/li>\n<li><span style=\"color: #000000;\">The skin lesions are extensive and are bilaterally symmetrical.<\/span><\/li>\n<li><span style=\"color: #000000;\">They are most severe at the cooler parts of the body.<\/span><\/li>\n<li><span style=\"color: #000000;\">This form of disease is associated with disfigurative lesions.<\/span><\/li>\n<li><span style=\"color: #000000;\">The skin of the face and forehead becomes thickened and corrugated, giving rise to typical leonine face.<\/span><\/li>\n<li><span style=\"color: #000000;\">The lateral part of the eyebrows may be lost.<\/span><\/li>\n<li><span style=\"color: #000000;\">Other disfiguring lesions include pendulous ear lobes, hoarseness of voice, involvement of cornea, perforation of the nasal septum, and nasal collapse.<\/span><\/li>\n<li><span style=\"color: #000000;\">Painless inguinal and axillary adenopathy, scarring of testis leading to sterility and gynecomastia are other complications.<\/span><\/li>\n<li><span style=\"color: #000000;\">Diffuse hyperanesthesia involving peripheral parts of extremities also occur due to involvement of the neural tissue.<\/span><\/li>\n<li><span style=\"color: #000000;\">Patients with lepromatous leprosy are anergic to <em> leprae <\/em>because of a defect in their cell-mediated immunity.<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Pathogenesis of Mycobacterium leprae M. leprae\u00a0is an acid-fast, gram-positive obligate intracellular bacillus that shows tropism for cells of the reticuloendothelial system and peripheral nervous system (notably Schwann cells). Organisms may &#8230; <a title=\"Pathogenesis and Clinical Manifestations of Mycobacterium leprae\" class=\"read-more\" href=\"https:\/\/microbenotes.com\/pathogenesis-and-clinical-manifestations-of-mycobacterium-leprae\/\" aria-label=\"Read more about Pathogenesis and Clinical Manifestations of Mycobacterium leprae\">Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":397,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[364],"tags":[381,382,409,412,533,534,535,536,537,538,552,323,563,570,605,685],"custom":{"td_video":"","featured_image":"https:\/\/microbenotes.com\/wp-content\/uploads\/2018\/02\/Pathogenesis-and-Clinical-Manifestations-of-Mycobacterium-leprae.jpg","author":{"name":"Sagar Aryal","avatar":"https:\/\/secure.gravatar.com\/avatar\/862472ea06500d4318f1ad82addb608e?s=96&d=mm&r=g"},"categories":[{"term_id":364,"name":"Bacteriology","slug":"bacteriology","term_group":0,"term_taxonomy_id":364,"taxonomy":"category","description":"<strong>Bacteriology is a branch or discipline of science that studies different characteristics of bacteria and their association with other organisms or disciplines.<\/strong>\r\n<ul>\r\n \t<li>Over the years, the discipline of bacteriology has evolved from the microbiological tests performed only by physicians, the application of the germ theory of disease and economic concerns relating to the spoilage of foods and wine to the use of bacteria to simpler forms of laboratory tests and the production of new nutritious food and antibiotics.<\/li>\r\n \t<li>The study of bacteria began with the discovery of the microscope and was mostly limited to experts and scientists of that time.<\/li>\r\n \t<li>The initial advances in pathogenic bacteriology began with the identification and characterization of bacteria associated with specific diseases.<\/li>\r\n \t<li>Nowadays, however, bacteriology is used in various other fields like food, pharmaceuticals, agriculture, and the environment.<\/li>\r\n \t<li>Significant advances made in bacteriology over the last century have resulted in the development of many useful vaccines like pneumococcal polysaccharide vaccine, diphtheria toxoid as well as antibiotics.<\/li>\r\n \t<li>At present, most bacterial diseases in humans and their infectious agents have been identified, although significant variants continue to evolve and sometimes emerge.<\/li>\r\n \t<li>Studies made in bacteriology have also allowed the use of gene recombination technology in bacteria to produce improved bacterial strains that can then be used in various areas.<\/li>\r\n \t<li>The importance of bacteriology continues to grow throughout the years as many diseases and disorders associated with almost all living beings are caused by bacteria.<\/li>\r\n \t<li>Studies of non-pathogenic bacteria that exist in a symbiotic relationship with plants and animals are even beneficial to said organisms.<\/li>\r\n \t<li>The identification and classification of bacteria into different groups have allowed for a convenient way of studying these bacteria and the formation of a separate branch, systemic bacteriology, that deals with taxonomy.<\/li>\r\n \t<li>Besides, bacteriological studies, subsequently, have also been divided into different areas like soil bacteriology, public-health bacteriology, industrial bacteriology, etc.<\/li>\r\n \t<li>Bacteriological studies have been the focal point for disease diagnosis and treatment, and their importance continues to grow with the emergence of new bacteria and associated diseases.<\/li>\r\n<\/ul>","parent":0,"count":124,"filter":"raw","cat_ID":364,"category_count":124,"category_description":"<strong>Bacteriology is a branch or discipline of science that studies different characteristics of bacteria and their association with other organisms or disciplines.<\/strong>\r\n<ul>\r\n \t<li>Over the years, the discipline of bacteriology has evolved from the microbiological tests performed only by physicians, the application of the germ theory of disease and economic concerns relating to the spoilage of foods and wine to the use of bacteria to simpler forms of laboratory tests and the production of new nutritious food and antibiotics.<\/li>\r\n \t<li>The study of bacteria began with the discovery of the microscope and was mostly limited to experts and scientists of that time.<\/li>\r\n \t<li>The initial advances in pathogenic bacteriology began with the identification and characterization of bacteria associated with specific diseases.<\/li>\r\n \t<li>Nowadays, however, bacteriology is used in various other fields like food, pharmaceuticals, agriculture, and the environment.<\/li>\r\n \t<li>Significant advances made in bacteriology over the last century have resulted in the development of many useful vaccines like pneumococcal polysaccharide vaccine, diphtheria toxoid as well as antibiotics.<\/li>\r\n \t<li>At present, most bacterial diseases in humans and their infectious agents have been identified, although significant variants continue to evolve and sometimes emerge.<\/li>\r\n \t<li>Studies made in bacteriology have also allowed the use of gene recombination technology in bacteria to produce improved bacterial strains that can then be used in various areas.<\/li>\r\n \t<li>The importance of bacteriology continues to grow throughout the years as many diseases and disorders associated with almost all living beings are caused by bacteria.<\/li>\r\n \t<li>Studies of non-pathogenic bacteria that exist in a symbiotic relationship with plants and animals are even beneficial to said organisms.<\/li>\r\n \t<li>The identification and classification of bacteria into different groups have allowed for a convenient way of studying these bacteria and the formation of a separate branch, systemic bacteriology, that deals with taxonomy.<\/li>\r\n \t<li>Besides, bacteriological studies, subsequently, have also been divided into different areas like soil bacteriology, public-health bacteriology, industrial bacteriology, etc.<\/li>\r\n \t<li>Bacteriological studies have been the focal point for disease diagnosis and treatment, and their importance continues to grow with the emergence of new bacteria and associated diseases.<\/li>\r\n<\/ul>","cat_name":"Bacteriology","category_nicename":"bacteriology","category_parent":0}]},"_links":{"self":[{"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/posts\/476"}],"collection":[{"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/comments?post=476"}],"version-history":[{"count":0,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/posts\/476\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/media\/397"}],"wp:attachment":[{"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/media?parent=476"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/categories?post=476"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/microbenotes.com\/wp-json\/wp\/v2\/tags?post=476"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}