scholarly journals A Challenging Case of Domestically Acquired Leprosy in the Southern United States

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Shruthi Mohan ◽  
Jessica K Fairley
Keyword(s):  
United States ◽  
Erythema Nodosum ◽  
The United States ◽  
Southern United States ◽  
Hansen's Disease ◽  
Hansen’S Disease ◽  
Erythema Nodosum Leprosum ◽  
Multibacillary Leprosy

Abstract Hansen’s disease (HD) is rare in the United States, but a steady number of cases are diagnosed annually, especially in southern areas where armadillos are present. Challenges associated with erythema nodosum leprosum (ENL), a complication of multibacillary leprosy, call for novel regimens. We present a case of a man with recalcitrant ENL from HD likely acquired in the United States. He required a combination of 4 drugs to control chronic ENL.

scholarly journals Mycobacterium lepromatosis as a Second Agent of Hansen’s Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Patrícia Deps ◽  
Simon M. Collin
Keyword(s):  
United States ◽  
Case Reports ◽  
The United States ◽  
Lepromatous Leprosy ◽  
Clinical Aspects ◽  
Red Squirrels ◽  
Hansen's Disease ◽  
Hansen’S Disease ◽  
Mycobacterium Lepromatosis

Mycobacterium lepromatosis was identified as a new species and second causal agent of Hansen’s disease (HD, or leprosy) in 2008, 150years after the disease was first attributed to Mycobacterium leprae. M. lepromatosis has been implicated in a small number of HD cases, and clinical aspects of HD caused by M. lepromatosis are poorly characterized. HD is a recognized zoonosis through transmission of M. leprae from armadillos, but the role of M. lepromatosis as a zoonotic agent of HD is unknown. M. lepromatosis was initially associated with diffuse lepromatous leprosy, but subsequent case reports and surveys have linked it to other forms of HD. HD caused by M. lepromatosis has been reported from three endemic countries: Brazil, Myanmar, and Philippines, and three non-endemic countries: Mexico, Malaysia, and United States. Contact with armadillos in Mexico was mentioned in 2/21 M. lepromatosis HD case reports since 2008. M. lepromatosis in animals has been investigated only in non-endemic countries, in squirrels and chipmunks in Europe, white-throated woodrats in Mexico, and armadillos in the United States. To date, there have only been a small number of positive findings in Eurasian red squirrels in Britain and Ireland. A single study of environmental samples found no M. lepromatosis in soil from a Scottish red squirrel habitat. Future studies must focus on endemic countries to determine the true proportion of HD cases caused by M. lepromatosis, and whether viable M. lepromatosis occurs in non-human sources.

scholarly journals Complex Type 2 Reactions in Three Patients with Hansen's Disease from a Southern United States Clinic

2015 ◽  
Vol 93 (5) ◽  
pp. 1082-1086 ◽  
Author(s):  
Kristoffer E. Leon ◽  
Jessica K. Fairley ◽  
Robert W. McDonald ◽  
Jorge L. Salinas ◽  
Anandi N. Sheth
Keyword(s):  
United States ◽  
Southern United States ◽  
Complex Type ◽  
Hansen's Disease ◽  
Hansen’S Disease

scholarly journals Delayed Diagnosis, Leprosy Reactions, and Nerve Injury Among Individuals With Hansen's Disease Seen at a United States Clinic

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Kristoffer E. Leon ◽  
Jesse T. Jacob ◽  
Carlos Franco-Paredes ◽  
Phyllis E. Kozarsky ◽  
Henry M. Wu ◽  
...  
Keyword(s):  
United States ◽  
Delayed Diagnosis ◽  
Retrospective Chart Review ◽  
The United States ◽  
Nerve Damage ◽  
Hansen's Disease ◽  
Delay In Diagnosis ◽  
Hansen’S Disease ◽  
Time Period ◽  
Delays In Diagnosis

Abstract Background.  Hansen's disease (HD), or leprosy, is uncommon in the United States. We sought to describe the characteristics of patients with HD in a US clinic, including an assessment of delays in diagnosis and HD reactions, which have both been associated with nerve damage. Methods.  A retrospective chart review was conducted on patients seen at an HD clinic in the southern United States between January 1, 2002 and January 31, 2014. Demographic and clinical characteristics were summarized, including delays in diagnosis, frequency of reactions, and other complications including peripheral neuropathy. Results.  Thirty patients were seen during the study time period. The majority of patients were male (73%) and had multibacillary disease (70%). Brazil, Mexico, and the United States were the most frequent of the 14 countries of origin. Hansen's disease “reactions”, severe inflammatory complications, were identified among 75% of patients, and nerve damage was present at diagnosis in 36% of patients. The median length of time between symptom onset and diagnosis was long at 12 months (range, 1–96), but no single factor was associated with a delay in diagnosis. Conclusions.  The diagnosis of HD was frequently delayed among patients referred to our US clinic. The high frequency of reactions and neuropathy at diagnosis suggests that further efforts at timely diagnosis and management of this often unrecognized disease is needed to prevent the long-term sequelae associated with irreversible nerve damage.

scholarly journals Pure neuritic leprosy presenting as ulnar nerve neuropathy: a case report of electrodiagnostic, radiographic, and histopathological findings

2015 ◽  
Vol 123 (5) ◽  
pp. 1238-1243 ◽  
Author(s):  
Russell Payne ◽  
Jennifer Baccon ◽  
John Dossett ◽  
David Scollard ◽  
Debra Byler ◽  
...  
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Peripheral Neuropathy ◽  
Ulnar Nerve ◽  
The United States ◽  
Health Concern ◽  
Radiographic Evaluation ◽  
Causative Organism ◽  
Hansen's Disease ◽  
Hansen’S Disease

Hansen’s disease, or leprosy, is a chronic infectious disease with many manifestations. Though still a major health concern and leading cause of peripheral neuropathy in the developing world, it is rare in the United States, with only about 150 cases reported each year. Nevertheless, it is imperative that neurosurgeons consider it in the differential diagnosis of neuropathy. The causative organism is Mycobacterium leprae, which infects and damages Schwann cells in the peripheral nervous system, leading first to sensory and then to motor deficits. A rare presentation of Hansen’s disease is pure neuritic leprosy. It is characterized by nerve involvement without the characteristic cutaneous stigmata. The authors of this report describe a case of pure neuritic leprosy presenting as ulnar nerve neuropathy with corresponding radiographic, electrodiagnostic, and histopathological data. This 11-year-old, otherwise healthy male presented with progressive right-hand weakness and numbness with no cutaneous abnormalities. Physical examination and electrodiagnostic testing revealed findings consistent with a severe ulnar neuropathy at the elbow. Magnetic resonance imaging revealed diffuse thickening and enhancement of the ulnar nerve and narrowing at the cubital tunnel. The patient underwent ulnar nerve decompression with biopsy. Pathology revealed acid-fast organisms within the nerve, which was pathognomonic for Hansen’s disease. He was started on antibiotic therapy, and on follow-up he had improved strength and sensation in the ulnar nerve distribution. Pure neuritic leprosy, though rare in the United States, should be considered in the differential diagnosis of those presenting with peripheral neuropathy and a history of travel to leprosy-endemic areas. The long incubation period of M. leprae, the ability of leprosy to mimic other conditions, and the low sensitivity of serological tests make clinical, electrodiagnostic, and radiographic evaluation necessary for diagnosis. Prompt diagnosis and treatment is imperative to prevent permanent neurological injury.

scholarly journals COVID-19 in persons affected by Hansen’s disease in Brazil

2020 ◽  
Author(s):  
Patrícia D. Deps ◽  
Taynah A. R. Repsold ◽  
Claudio G. Salgado ◽  
Raquel de Carvalho Bouth ◽  
Selma Regina Penha Silva Cerqueira ◽  
...  
Keyword(s):  
Erythema Nodosum ◽  
Population Level ◽  
Hansen's Disease ◽  
The Third ◽  
Hansen’S Disease ◽  
Erythema Nodosum Leprosum ◽  
Almost All ◽  
Severe Type ◽  
Related Mortality

AbstractBackgroundHansen’s disease (HD) is endemic in Brazil, a country with the third highest number of COVID-19 cases in the world and the second highest number of COVID-19 deaths. COVID-19 in persons affected by HD has not been described at population level in this country.MethodsWe collated numbers of COVID-19 cases and deaths among patients who were receiving routine treatment for HD at six centres across Brazil (Belém, Bauru, Brasília, Vitória, Petrolina, Palmas) between 1st March and 10th December 2020.ResultsOf 1,333 HD patients receiving treatment, 70 (5.2%) reported having had COVID-19. Almost all patients (97% (1,296/1,333)) including all but one of the COVID-19 cases were receiving MDT comprising rifampicin (600mg once per month), dapsone (100mg daily), and clofazimine (50 mg daily plus 300 mg once per month). Four patients died, including a patient in their 30’s on MDT who had a severe type 2 HD reaction (erythema nodosum leprosum) and who was taking clofazimine 100mg daily.ConclusionsWe cannot determine from these preliminary data whether persons affected by Hansen’s disease have a higher or lower risk of COVID-19 and related mortality compared with the general population. We will continue to monitor the effects of COVID-19 in persons affected by and treated for HD and extend this to monitor SARS-CoV-2 vaccine effectiveness in this group of patients.

Lepromin Skin Testing in the Classification of Hansen's Disease in the United States

1993 ◽  
Vol 305 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Wojciech A. Krotoski ◽  
Tomasz F. Mroczkowski ◽  
Thomas H. Rea ◽  
Pablo I. Almodovar ◽  
Bruce C. Clements ◽  
...  
Keyword(s):  
United States ◽  
Skin Testing ◽  
The United States ◽  
Hansen's Disease ◽  
Hansen’S Disease
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