SHORT REPORT: TREATMENT FAILURE IN HANSEN’S DISEASE

CLINTON K. MURRAY Brooke Army Medical Center, Fort Sam Houston, Texas; National Hansen’s Disease Programs, Baton Rouge, Louisiana; Medicine Specialty Services, University of Texas at Tyler, San Antonio, Texas

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M. PATRICIA JOYCE Brooke Army Medical Center, Fort Sam Houston, Texas; National Hansen’s Disease Programs, Baton Rouge, Louisiana; Medicine Specialty Services, University of Texas at Tyler, San Antonio, Texas

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ROBERT N. LONGFIELD Brooke Army Medical Center, Fort Sam Houston, Texas; National Hansen’s Disease Programs, Baton Rouge, Louisiana; Medicine Specialty Services, University of Texas at Tyler, San Antonio, Texas

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Areas of low endemicity of Hansen’s disease, such as Texas, California, and Hawaii, exist due to immigration and rare autochthonous infections. Managing this disease in these areas of low endemicity is difficult, especially in observing for relapse. The accurate diagnosis of relapse is imperative so that appropriate therapy can be promptly reinstituted and unnecessary treatment can be avoided. To assess treatment failures in an area of low endemicity, we retrospectively evaluated 113 patients with Hansen’s disease treated in southern Texas. Of 57 patients who completed therapy, 11 were later restarted on medications for this disease for presumed relapse. However, nine of the 11 were found not to have true relapses of Hansen’s disease. The accurate diagnosis of relapse of this disease is essential not only in the individual patient but also for prospective treatment trials to establish best practices.

Author Notes

Reprint requests: Clinton K. Murray, Department of Medicine, Infectious Diseases Service, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234-6200, Telephone: 210-916-5554, Fax: 210-916-0388, E-mail: Clinton.Murray@AMEDD.ARMY.MIL.
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