A Case of Fluoroquinolone-Resistant Leprosy Discovered after 9 Years of Misdiagnosis

We report a case of misdiagnosed leprosy in a 21-year-old Malagasy male, who, improperly treated, developed secondary mycobacterial resistance to fluoroquinolone. The patient contracted the infection 9 years prior to the current consultation, displaying on the right thigh a single papulonodular lesi...

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Published in:Case reports in infectious diseases 2016-01, Vol.2016 (2016), p.1-4
Main Authors: Rabenja, Fahafahantsoa Rapelanoro, Rakoto-Andrianarivelo, Mala, Andrianarison, M., Sendrasoa, F. A., Ranaivo, I. M., Ramarozatovo, L. S., Raharolahy, O., Cambau, Emmanuelle
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Case studies
Diagnosis
Leprosy
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creator Rabenja, Fahafahantsoa Rapelanoro
Rakoto-Andrianarivelo, Mala
Andrianarison, M.
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Ramarozatovo, L. S.
Raharolahy, O.
Cambau, Emmanuelle
description We report a case of misdiagnosed leprosy in a 21-year-old Malagasy male, who, improperly treated, developed secondary mycobacterial resistance to fluoroquinolone. The patient contracted the infection 9 years prior to the current consultation, displaying on the right thigh a single papulonodular lesion, which progressively spread to the lower leg, back, and face. Initial administration of ciprofloxacin and prednisolone led to temporary and fluctuating improvement. Subsequent long-term self-medication with ciprofloxacin and corticosteroid did not heal the foul and nonhealing ulcers on the legs and under the right sole. Histopathological findings were compatible with lepromatous leprosy. Skin biopsy was positive for acid-fast bacilli and PCR assay confirmed the presence of a fluoroquinolone-resistant strain of Mycobacterium leprae (gyrA A91V). After 6 months of standard regimen with rifampicin, clofazimine, and dapsone, clinical outcome significantly improved. Clinical characteristics and possible epidemiological implications are discussed.
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Subsequent long-term self-medication with ciprofloxacin and corticosteroid did not heal the foul and nonhealing ulcers on the legs and under the right sole. Histopathological findings were compatible with lepromatous leprosy. Skin biopsy was positive for acid-fast bacilli and PCR assay confirmed the presence of a fluoroquinolone-resistant strain of Mycobacterium leprae (gyrA A91V). After 6 months of standard regimen with rifampicin, clofazimine, and dapsone, clinical outcome significantly improved. 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subjects Care and treatment
Case Report
Case studies
Diagnosis
Leprosy
title A Case of Fluoroquinolone-Resistant Leprosy Discovered after 9 Years of Misdiagnosis
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