Joel Chandranesan Andrew Stevenson, Mada Pradeep Kumar, Ramos-Herberth Frances, Walsworth David, Penn Robert, Washburn Ronald
Department of Infectious Diseases, LSU Health Sciences Center, Shreveport, LA, USA.
Department of Infectious Diseases, LSU Health Sciences Center; Department of Infectious Diseases, Shreveport VA Medical Center, Shreveport, LA, USA.
Int J Mycobacteriol. 2018 Apr-Jun;7(2):173-177. doi: 10.4103/ijmy.ijmy_21_18.
Hansen's disease, commonly known as leprosy, is a chronic mycobacterial infection caused by Mycobacterium leprae. Although generally uncommon in the United States, it is endemic in the Southern United States. We diagnosed and managed five leprosy patients from Northwest Louisiana, each presenting a distinct set of challenges. A retrospective study was performed to collect demographic, clinical, and laboratory data from our cases. The information was analyzed with a specific focus on associated factors, diagnosis, and management. The mean age at diagnosis was 67.6 years (range 56-83 years), and the average delay in diagnosis was 8.4 months (range 1-20 months). All five patients presented with nonhealing rashes, and three initially sought help from primary care providers. Only two patients developed subjective numbness. Leprosy was not suspected before skin biopsy in three cases, while noninfectious diagnoses were considered, including mycosis fungoides, erythema multiforme, vasculitis, and amyloidosis. In the other two cases, leprosy was in the initial differential diagnosis. Ultimately, the diagnosis of leprosy was established in all five individuals based on clinical presentation, routine histopathology, and tissue acid-fast staining. This case series highlights the importance of leprosy, especially in the Southern United States where its incidence is increasing.
麻风病，俗称“癞病”，是由麻风分枝杆菌引起的一种慢性分枝杆菌感染。虽然在美国总体上并不常见，但在美国南部却是地方病。我们诊断并治疗了来自路易斯安那州西北部的5例麻风病患者，每例都带来了一系列独特的挑战。我们进行了一项回顾性研究，以收集这些病例的人口统计学、临床和实验室数据。对这些信息进行了分析，特别关注相关因素、诊断和治疗。诊断时的平均年龄为67.6岁（范围为56 - 83岁），诊断的平均延迟时间为8.4个月（范围为1 - 20个月）。所有5例患者均有不愈合的皮疹，3例最初向初级保健提供者寻求帮助。只有2例患者出现主观麻木感。3例在皮肤活检前未怀疑患有麻风病，当时考虑的是非感染性诊断，包括蕈样肉芽肿、多形红斑、血管炎和淀粉样变性。在另外2例中，麻风病在最初的鉴别诊断中。最终，根据临床表现、常规组织病理学和组织抗酸染色，所有5例患者均确诊为麻风病。该病例系列强调了麻风病的重要性，特别是在美国南部，其发病率正在上升。
