Kama G, Huang G K L, Taune M, Arura R, Morris L, Kombuk B, Marome A, O'Brien D P
Daru General Hospital, Daru, Western Province, Papua New Guinea (PNG).
Burnet Institute, Melbourne, Victoria, Australia.
Public Health Action. 2019 Sep 21;9(Suppl 1):S83-S85. doi: 10.5588/pha.18.0104.
Co-infection with tuberculosis (TB) and leprosy is thought to occur infrequently, but has been reported in settings highly endemic for both infectious diseases. We report for the first time a case where treatment for multidrug-resistant TB (MDR-TB) led to the 'unmasking' of clinically silent leprosy through the precipitation of a type-1 immunological reaction. Current treatment regimens for MDR-TB may contain a number of drugs, such as levo-floxacin and clofazimine, which also have activity against M. leprae. A treatment regimen containing drugs active against both mycobacterial species may be used to achieve cure. Individual considerations on drug-drug interactions, potential additive toxicities and other comorbidities should be taken into account.
结核病（TB）和麻风病的合并感染被认为很少发生，但在这两种传染病的高流行地区已有相关报道。我们首次报告了一例耐多药结核病（MDR-TB）治疗导致临床隐匿性麻风病通过1型免疫反应的激发而“暴露”的病例。目前的耐多药结核病治疗方案可能包含多种药物，如左氧氟沙星和氯法齐明，这些药物对麻风杆菌也有活性。含有对两种分枝杆菌都有活性的药物的治疗方案可用于实现治愈。应考虑药物相互作用、潜在的累加毒性和其他合并症等个体因素。
