Jariyakulwong Niporn, Julanon Narachai, Saengboonmee Charupong
Lamplaimat Hospital, Lamplaimat, Buriram, Thailand.
Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
J Taibah Univ Med Sci. 2022 Feb 1;17(4):602-605. doi: 10.1016/j.jtumed.2021.12.005. eCollection 2022 Aug.
This report aims to demonstrate and remind healthcare providers that, despite being considered eradicated in a specific area, leprosy can still be found due to its unusually long incubation period.
A case of leprosy has been reported in a 48-year-old Thai woman who presented classic dermatological and neurological symptoms. A physical examination and slit smear preparation with acid-fast staining was performed to fulfil the diagnostic criteria of the World Health Organization (WHO). Therapeutic regimens were prescribed according to WHO recommendations.
A patient was diagnosed with leprosy given that all cardinal signs of WHO diagnostic criteria were met after both physical and microscopic examinations. Physical examination of the skin lesions revealed the lepromatous type. Slit smear preparation of the lesions revealed abundant acid-fast bacilli. The patient has been living solely in an area where leprosy has been practically eradicated, with no new cases reported. The most likely cause of her infection is her close contact with a leprosy-infected family member 30 years ago, with whom she shared a house for a week.
This report describes a rare case of leprosy with a long incubation period in a non-endemic area. Only non-human primates have had such an unusually long incubation period, which is extremely rare in humans. This information reminds healthcare providers that leprosy is not a disease of the past, and a careful surveillance program for leprosy remains necessary, even in eradicated areas.
本报告旨在向医疗服务提供者证明并提醒他们，尽管麻风病在特定地区被认为已被根除，但由于其异常长的潜伏期，仍可能被发现。
报告了一例48岁泰国女性的麻风病病例，该患者出现了典型的皮肤和神经症状。进行了体格检查和抗酸染色的涂片检查，以符合世界卫生组织（WHO）的诊断标准。根据WHO的建议开出了治疗方案。
经体格检查和显微镜检查后，该患者符合WHO诊断标准的所有主要体征，因此被诊断为麻风病。对皮肤病变的体格检查显示为瘤型。病变的涂片检查发现大量抗酸杆菌。该患者一直独自生活在一个实际上已根除麻风病的地区，没有新病例报告。她感染的最可能原因是30年前与一名麻风病感染家庭成员密切接触，当时她与该家庭成员共住了一周。
本报告描述了一例非流行地区罕见的潜伏期长的麻风病病例。只有非人类灵长类动物有如此异常长的潜伏期，这在人类中极为罕见。这一信息提醒医疗服务提供者，麻风病并非过去的疾病，即使在已根除的地区，对麻风病进行仔细的监测计划仍然必要。
