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一名被误诊为睾丸结核的瘤型麻风反应患者的诊断延误。

Diagnostic delay in a patient with reactional lepromatous leprosy treated as testicular tuberculosis.

作者信息

Ferreira Mayara Elisa Batista, Diniz Lucia Martins, Spelta Karla, Lucas Elton Almeida

机构信息

Dermatology Service, Universidade Federal do Espírito Santo, Vitória (ES), Brazil.

Department of Internal Medicine, Discipline of Dermatology, Universidade Federal do Espírito Santo, Vitória (ES), Brazil.

出版信息

An Bras Dermatol. 2019 Mar-Apr;94(2):236-238. doi: 10.1590/abd1806-4841.20198327. Epub 2019 May 9.

DOI:10.1590/abd1806-4841.20198327
PMID:31090835
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6486085/
Abstract

Leprosy is a chronic neglected and stigmatizing disease. Due to involvement of the peripheral nerves, it can result in physical disabilities, deformities, and emotional damage if not diagnosed and treated promptly. This is the case of a young patient with testicular pain and swelling and no improvement after a specific therapeutic scheme for tuberculosis. Clinical and laboratory reevaluation revealed hypoesthetic skin patches associated with post-burn crusted ulcers on the left arm, thickening of ulnar nerves, atrophy of interosseous muscles of the hands, positive skin smear microscopy, and testicular histopathology with numerous bacilli forming globi. These findings indicated lepromatous leprosy with type II reaction.

摘要

麻风病是一种长期被忽视且带有污名化的慢性疾病。由于周围神经受累,如果不及时诊断和治疗,可能会导致身体残疾、畸形和情感创伤。本文讲述的是一名年轻患者,他出现睾丸疼痛和肿胀,在接受针对结核病的特定治疗方案后病情未改善。临床和实验室重新评估发现,患者左臂有感觉减退的皮肤斑块,伴有烧伤后结痂溃疡,尺神经增粗,手部骨间肌萎缩,皮肤涂片显微镜检查呈阳性,睾丸组织病理学检查发现大量杆菌形成菌球。这些发现表明为瘤型麻风伴Ⅱ型反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/6486085/c1e973b4a958/abd-94-02-0236-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/6486085/6cdd4aa7d502/abd-94-02-0236-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/6486085/4f93bf6f5452/abd-94-02-0236-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/6486085/b14e64e08b2f/abd-94-02-0236-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/6486085/c1e973b4a958/abd-94-02-0236-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/6486085/6cdd4aa7d502/abd-94-02-0236-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/6486085/4f93bf6f5452/abd-94-02-0236-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/6486085/b14e64e08b2f/abd-94-02-0236-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/27da/6486085/c1e973b4a958/abd-94-02-0236-g04.jpg

相似文献

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Diagnostic delay in a patient with reactional lepromatous leprosy treated as testicular tuberculosis.一名被误诊为睾丸结核的瘤型麻风反应患者的诊断延误。
An Bras Dermatol. 2019 Mar-Apr;94(2):236-238. doi: 10.1590/abd1806-4841.20198327. Epub 2019 May 9.
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本文引用的文献

1
Leprosy: ancient disease remains a public health problem nowadays.麻风病:古老的疾病如今仍是一个公共卫生问题。
An Bras Dermatol. 2016 Jul-Aug;91(4):547-8. doi: 10.1590/abd1806-4841.20164861.
2
Brazilian Society of Dermatology against leprosy.巴西皮肤病学会防治麻风病。
An Bras Dermatol. 2016 May-Jun;91(3):393-5. doi: 10.1590/abd1806-4841.20164648.