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Case Report: Diagnostic Pitfalls in an Atypical Case of Primary Neuritic Leprosy

Winnie OoiBoston Hansen’s Clinic, Division of Infectious Diseases, Beth Israel Lahey Health, Burlington, Massachusetts;

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Shrein SainiDepartment of Infectious Disease and Geographical Medicine, Tufts Medical Center, Boston, Massachusetts

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ABSTRACT.

Primary neuritic leprosy is a form of leprosy clinically limited to the peripheral nerves without obvious skin lesions. Diagnosing leprosy in the absence of typical dermatological features is challenging and often causes a delay in diagnosis. We describe a case of primary neuritic leprosy with atypical features and the roles that histological confirmation using nerve biopsy of an unenlarged nerve and newer techniques, such as polymerase chain reaction and high-resolution ultrasonography, play in improving the diagnosis.

Author Notes

Address correspondence to Winnie Ooi, Boston Hansen’s Clinic, Division of Infectious Diseases, Beth Israel Lahey Health, 41 Mall Road, Burlington, MA 01805. E-mail: winnie.w.ooi@lahey.org

Authors’ addresses: Winnie Ooi, Boston Hansen’s Clinic, Division of Infectious Diseases, Beth Israel Lahey Health, Burlington, MA, E-mail: winnie.w.ooi@lahey.org. Shrein Saini, Department of Infectious Disease and Geographical Medicine, Tufts Medical Center, Boston, MA, E-mail: ssaini1@tuftsmedicalcenter.org.

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