Weissman J B, Neu H C
Am J Med. 1979 Jul;67(1):113-6. doi: 10.1016/0002-9343(79)90081-0.
A patients with disseminated leprosy is described. A 57 year old man from Cuba presented with fever and pancytopenia. Bone marrow aspirate showed numerous acid-fast bacilli and a liver biopsy specimen contained multiple granulomas. The patient was considered to have tuberculosis and was treated with isoniazid and rifampin, with initial clinical improvement, only to have the fever recur and to show deterioration in hematologic and hepatic function. Failure to grow M. tuberculosis suggested a diagnosis of leprosy which was proved by skin biopsy. How lepromatous leprosy can masquerade as disseminated tuberculosis is discussed.
本文描述了一名播散性麻风患者。一名来自古巴的57岁男性，出现发热和全血细胞减少。骨髓穿刺显示大量抗酸杆菌，肝脏活检标本中有多个肉芽肿。该患者最初被诊断为肺结核，并接受异烟肼和利福平治疗，初期临床症状有所改善，但随后发热复发，血液学和肝功能恶化。结核分枝杆菌培养阴性提示麻风诊断，皮肤活检证实了这一诊断。本文还讨论了瘤型麻风如何伪装成播散性肺结核。
