Case Report: Lepromatous Leprosy Masquerading as Acute Suppurative Lymphadenitis

Mahadev Meena Department of Medicine, All India Institute of Medical Sciences, Bhopal, India;

Search for other papers by Mahadev Meena in
Current site
Google Scholar
PubMed
Close
,
Rajnish Joshi Department of Medicine, All India Institute of Medical Sciences, Bhopal, India;

Search for other papers by Rajnish Joshi in
Current site
Google Scholar
PubMed
Close
,
Vaibhav Yadav Department of Medicine, All India Institute of Medical Sciences, Bhopal, India;

Search for other papers by Vaibhav Yadav in
Current site
Google Scholar
PubMed
Close
,
Prachi Singh Department of Medicine, All India Institute of Medical Sciences, Bhopal, India;

Search for other papers by Prachi Singh in
Current site
Google Scholar
PubMed
Close
,
Shreya K Department of Dermatology, All India Institute of Medical Sciences, Bhopal, India;

Search for other papers by Shreya K in
Current site
Google Scholar
PubMed
Close
, and
Garima Pandey Department of Pathology, All India Institute of Medical Sciences, Bhopal, India

Search for other papers by Garima Pandey in
Current site
Google Scholar
PubMed
Close
Restricted access

ABSTRACT.

Leprosy is a chronic cutaneous infection. It is usually characterized by thickened nerves and maculo-anesthetic patches. Leprosy often has an unusual presentation, which is a diagnostic challenge. In this case report, we present a case of an elderly male who presented with fever and chronic pus-draining axillary, cervical, and inguinal lymph nodes. He also had a weak left foot for the previous 5 months. During his hospital stay, he developed additional papular lesions over his extremities. We performed fine needle aspiration from the lymph nodes and skin biopsy, which were suggestive of lepromatous leprosy. We initiated him on antileprosy medication. On follow-up, he was responsive to therapy. Although skin and nerve involvement in leprosy is common, this case had an atypical presentation of discharging lymph nodes.

Author Notes

Address correspondence to Mahadev Meena, Department of Medicine, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, India. E-mail: drmahadev.snmc@gmail.com

Authors’ addresses: Mahadev Meena, Rajnish Joshi, Vaibhav Yadav, and Prachi Singh, Department of Medicine, All India Institute of Medical Sciences, Bhopal, India, E-mails: drmahadev.snmc@gmail.co, rajnish.genmed@aiimsbhopal.edu.in, vaibhav1125.90@gmail.com, and prachi4bharat@gmail.com. Shreya K, Department of Dermatology, All India Institute of Medical Sciences, Bhopal, India, E-mail: shreyakgowda@gmail.com. Garima Pandey, Department of Pathology, All India Institute of Medical Sciences, Bhopal, India, E-mail: mygarima1993@gmail.com.

  • 1.

    World Health Organization , 2019. Global Leprosy (Hansen Disease) Update, 2019: Time to Step-Up Prevention Initiatives. Available at: https://apps.who.int/iris/bitstream/handle/10665/334140/WER9536-eng-fre.pdf?sequence=1&isAllowed=y. Accessed May 24, 2021.

    • PubMed
    • Export Citation
  • 2.

    Moschella SL , 2004. An update on the diagnosis and treatment of leprosy. J Am Acad Dermatol 51: 417–426.

  • 3.

    Scollard DM , Adams LB , Gillis TP , Krahenbuhl JL , Truman RW , Williams DL , 2006. The continuing challenges of leprosy. Clin Microbiol Rev 19: 338–381.

  • 4.

    Desikan KV , 2012. Elimination of leprosy & possibility of eradication – the Indian scenario. Indian J Med Res 135: 3–5.

  • 5.

    Goyal T , Varshney A , Bakshi SK , Sharma V , 2015. Lymph node abscess and cardiac involvement in a patient with nodular lepromatous leprosy (LL) with erythema nodosum leprosum (ENL): a rare occurrence. Lepr Rev 86: 112–116.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Karat AB , Karat S , Job CK , Sudarsanam D , 1968. Acute necrotizing lepromatous lymphadenitis: an erythema-nodosum-leprosum-like reaction in lymph nodes. BMJ 4: 223–224.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Bjorvatn B , Barnetson RS , Kronvall G , 1976. Immune complexes and complement hypercatabolism in patients with leprosy. Clin Exp Immunol 26: 388–396.

  • 8.

    Nath I , Vemuri N , Reddi AL , Jain S , Brooks P , Colston MJ , Misra RS , Ramesh V , 2000. The effect of antigen-presenting cells on the cytokine profiles of stable and reactional lepromatous leprosy patients. Immunol Lett 75: 69–76.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 2342 2342 52
Full Text Views 345 345 93
PDF Downloads 85 85 1
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save