Constant-Desportes M, Guelpa-Lauras C C, Carolina J C, Léoture A, Grosset J H, Sansarricq H
Hôpital Clarac, Centre Hospitalier Regional Universitaire de Fort-de-France, Martinique, French West Indies.
Int J Lepr Other Mycobact Dis. 1991 Jun;59(2):242-7.
A male born in 1930 was diagnosed as smear-positive borderline leprosy in 1971, and was treated with dapsone and/or sulfamethoxypyridazine from 1972 to 1980 with clinical improvement. However, new skin lesions with smears strongly positive appeared in August 1980, and he was diagnosed as having downgraded to lepromatous (LL) leprosy, but the bacilli recovered from the skin biopsy were fully susceptible to both dapsone and rifampin by mouse foot pad technique. Between 1981 and 1983, the patient was treated with 24 months of rifampin 600 mg and dapsone 100 mg daily, supplemented with prothionamide 500 mg daily during the initial 3 months, and his skin lesions gradually improved during treatment with the combined regimen. Afterward, the patient was kept under surveillance without treatment. From 1984 to 1986, his skin smears were negative, and no bacilli could be found from a skin biopsy taken in 1985. Then in 1987, 52 months after stopping treatment, new skin lesions appeared with a high concentration of Mycobacterium leprae (2 x 10(6)/mg tissue). The drug-susceptibility test again demonstrated that the organisms were fully susceptible to both dapsone and rifampin. Apparently the relapse was due to remultiplication of drug-susceptible persisters.
一名出生于1930年的男性在1971年被诊断为涂片阳性边缘型麻风，1972年至1980年期间接受了氨苯砜和/或磺胺甲氧嗪治疗，临床症状有所改善。然而，1980年8月出现了涂片强阳性的新皮肤损害，他被诊断为降级为瘤型（LL）麻风，但通过小鼠足垫技术从皮肤活检中分离出的杆菌对氨苯砜和利福平均完全敏感。1981年至1983年期间，该患者接受了为期24个月的每日600毫克利福平和100毫克氨苯砜治疗，最初3个月每日补充500毫克丙硫异烟胺，联合治疗期间皮肤损害逐渐改善。此后，患者未接受治疗并接受监测。1984年至1986年期间，他的皮肤涂片为阴性，1985年的皮肤活检未发现杆菌。然后在1987年，即停止治疗52个月后，出现了新的皮肤损害，麻风杆菌浓度很高（2×10⁶/毫克组织）。药敏试验再次表明这些菌株对氨苯砜和利福平均完全敏感。显然，复发是由于药敏性持续菌的重新繁殖。
