Gálvez J, López-Domínguez J M, Navarro A, Creagh R, Casado J L, Chinchón Lara I
Servicio de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva.
Neurologia. 1998 Jan;13(1):41-4.
We describe a patient with a diagnosis of Hansen's disease borderline type, presenting as cutaneous lesions and silent multineuritis. Samples of nasal mucus, earlobe and cutaneous lesions were positive for acid-fast bacilli. He was given treatment with rifampin, dapsone and clofazimine. Five years later, he developed fever, poliarthritis, orchitis and hepatic involvement. Searching for acid-fast bacilli in many cutaneous and mucosal locations was fruitfulness. Because of clinical suspicion of erythema nodosum leprosum, he was treated with steroids with improvement of his clinical picture, but subsequently he developed multineuritis with many sensitive symptoms. A high number of bacilli was seen in nerve biopsy. We comment on atypical features of clinical evolution and erythema nodosum leprosum, and emphasize the significance of large number of bacilli into peripheral nerve in contrast with their absence at other levels.
我们描述了一名被诊断为边缘型汉森病的患者，表现为皮肤病变和隐匿性多神经炎。鼻黏液、耳垂和皮肤病变样本的抗酸杆菌检测呈阳性。他接受了利福平、氨苯砜和氯法齐明治疗。五年后，他出现发热、多关节炎、睾丸炎和肝脏受累。在许多皮肤和黏膜部位查找抗酸杆菌均有收获。由于临床怀疑为结节性红斑麻风，他接受了类固醇治疗，临床症状有所改善，但随后出现了伴有许多敏感症状的多神经炎。神经活检中可见大量杆菌。我们对临床病程和结节性红斑麻风的非典型特征进行了评论，并强调了外周神经中存在大量杆菌而其他部位没有的重要意义。
