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The Egyptian Journal of Internal Medicine
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Leprosy, a Pleitropic infectious disease: a challenging diagnosis

The Egyptian Journal of Internal Medicine volume 30, pages 40–42 (2018)Cite this article

Abstract

This is a case report of 22-year-old man who was suffering from epididymo-orchitis for more than 2 years. Several months after the onset of the condition, the patient developed bilateral upper-limb and lower-limb numbness and tingling sensation with hypothesia, which was further complicated by nonhealing foot ulcer, arthralgia, and generalized maculopapular skin rash. The patient was initially managed as rheumatoid arthritis associated with vasculitis, which was later diagnosed as lepromatous leprosy. Musculoskeletal complaints are not exclusive to only autoimmune diseases; it can also be observed in several disorders, such as infectious diseases. It is challenging for any physician to properly diagnose patients with leprosy as differentiating leprosy from other systemic rheumatic disease is pivotal.

References

  1. Walker SL, Lockwood DNJ. The clinical and immunological features of leprosy. Br Med Bull 2006; 77–78: 103–121.

    Article  Google Scholar 

  2. Cole ST, Singh P. History and phylogeography of leprosy. In: Nunzi E, Massone C, editors. Leprosy. Milano: Springer Milan; 2012. pp. 3–11.

    Chapter  Google Scholar 

  3. El-Gendy H, El-Gohary R, Shohdy K, Ragab G. Leprosy masquerading as systemic rheumatic diseases. J Clin Rheumatol 2016; 22:164–271.

    Article  Google Scholar 

  4. Britton WJ, Lockwood DNJ. Leprosy. Lancet 2004; 363:1209–1219.

    Article  Google Scholar 

  5. Nigam P, Mukhija RD, Gupta AK, Dayal SG, Goyal BM. Gonadal involvement in leprosy: study of gynaecomastia, testicular and epididymal involvement and therapeutic efficacy of indigenous drugs. Hansenol Int 1984; 9:10–20.

    CAS  PubMed  Google Scholar 

  6. Bartt RE. Leprosy (Hansen’s disease). Curr Treat Options Neurol 2004; 6:95–103.

    Article  Google Scholar 

  7. Ridley DS, Jopling WH. Classification of leprosy according to immunity. A five-group system. Int J Lepr Other Mycobact Dis 1966; 34: 255–273.

    CAS  PubMed  Google Scholar 

  8. de Oliveira Fernandes TRM, Korinfskin JP, Espíndola MMM, de Oliveira Corrêa LM. Arthritis and diagnosis of leprosy: a case report and review of the literature. An Bras Dermatol 2014; 89:323–325.

    Article  Google Scholar 

  9. Khanolkat VR. Pathology in leprosy. In: Leprosy in theory and practice. 1964; pp. 131–132.

  10. Ghorpade A, Ramanam C. Primary penile tuberculoid leprosy. Indian J Lepr 2000; 72:499–500.

    CAS  PubMed  Google Scholar 

  11. Muir E. Lepra reaction and the general adaptation syndrome. Lep Rev 1962; 33:240–251.

    Google Scholar 

  12. Mahajan R, Dogra S, Kaur I, Yadav S, Saikia UN, Budania A. Type II reaction without erythema nodosum leprosum masquerading as lymphoma. Lepr Rev 2012; 83:378–383.

    PubMed  Google Scholar 

  13. Marahatta S, Agrawal S, Paudyal P. Difficult diagnosis and challenging treatment – a report on leprosy. Lepr Rev 2016; 87:543–547.

    PubMed  Google Scholar 

  14. Tilak T. Acute epididymo-orchitis in lepromatous leprosy. Lep Rev 1968; 39:31–36.

    Google Scholar 

  15. Faten A, Seham A, Abeer M, Asmaa S, Omima M. Testicular function in male patients with lepromatous leprosy. Egypt J Dermatol Venereol 2014; 34:41–45.

    Article  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Cairo University, 11562, Cairo, Egypt

    Manal El Meniawy, Mervat Essam MD & Ymna Khaled

Authors
  1. Manal El Meniawy
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  2. Mervat Essam MD
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  3. Ymna Khaled
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Correspondence to Mervat Essam MD.

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Meniawy, M.E., Essam, M. & Khaled, Y. Leprosy, a Pleitropic infectious disease: a challenging diagnosis. Egypt J Intern Med 30, 40–42 (2018). https://doi.org/10.4103/ejim.ejim_44_17

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  • DOI: https://doi.org/10.4103/ejim.ejim_44_17

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