Apparent exacerbation of Hansen's disease despite appropriate antimicrobial therapy

In 1991, the World Health Organization and its member states resolved to reduce the global prevalence of Hansen's disease (leprosy) by at least 90%. Despite its waning prevalence, however, the disease remains endemic in parts of Africa, Asia, and Latin America. Moreover, imported cases are occa...

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Bibliographic Details
Published in:Military medicine 2003-11, Vol.168 (11), p.893-895
Main Authors: ZAPOR, Michael, KAPLAN, Keith, HAWKES, Clifton
Format: Article
Language:English
Subjects:
Adult
Bacterial diseases
Biological and medical sciences
Dapsone - therapeutic use
Human bacterial diseases
Humans
Infectious diseases
Leprosy
Leprosy, Tuberculoid - diagnosis
Leprosy, Tuberculoid - drug therapy
Male
Medical sciences
Rifampin - therapeutic use
Treatment Outcome
Tropical bacterial diseases
Tropical medicine
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Summary:In 1991, the World Health Organization and its member states resolved to reduce the global prevalence of Hansen's disease (leprosy) by at least 90%. Despite its waning prevalence, however, the disease remains endemic in parts of Africa, Asia, and Latin America. Moreover, imported cases are occasionally encountered innonendemic areas. This fact, coupled with the current tempo of overseas deployments, makes it imperative that military physicians familiarize themselves with both the presentation and potential complications of Hansen's disease. Here, we present the case of a soldier referred to Walter Reed Army Medical Center for apparent worsening of his disease despite appropriate antibiotic therapy. On evaluation, the patient was diagnosed with reversal reaction, an immune-mediated phenomenon resembling disease exacerbation and requiring prompt intervention to avert lasting sequelae. Following the case presentation, we discuss the clinical manifestations, pathophysiology, and management of reversal reactions as well as the related entity erythema nodosum leprosum.
ISSN:0026-4075
1930-613X
DOI:10.1093/milmed/168.11.893