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- Title
Report on an unusual case of leprosy from Germany: just an exception of the rule?
- Authors
Saar, Malkin; Hanus, Ingrid; Huber, Kristina; Beissner, Marcus; Löscher, Thomas; Bretzel, Gisela
- Abstract
Case presentation: We report on a German leprosy patient originating from Pakistan who had a relapse more than 5 years after completion of multi-drug therapy (MDT) of his first episode of multibacillary (MB) leprosy. State-of-the-art laboratory techniques (histopathology, PGL-I serology, microscopy and DNA/RNA qPCR) were applied for laboratory confirmation and monitoring of treatment outcome. Serology indicated the relapse long before the presence of unambiguous clinical signs. At the time of diagnosis of the relapse the patient had a remarkably high bacterial load suggesting increased risk for a second relapse. Furthermore, unexpectedly prolonged excretion of viable bacilli through the upper respiratory tract for more than 3 months after onset of MDT was shown. Therefore, MDT was administered for 2 years. Discussion and conclusions: The clinical course of the patient, as well as the prolonged excretion of viable bacilli, underlines the usefulness of laboratory assessment. Laboratory tools including up-to-date molecular assays facilitate rapid diagnosis, timely MDT, identification of individuals excreting viable bacilli and patients at risk for relapses, monitoring of treatment outcome and respective adaptation of treatment where appropriate.
- Subjects
PAKISTAN; GERMANY; DRUG therapy for Hansen's disease; HANSEN'S disease diagnosis; DISEASE relapse; ANTI-infective agents; CLINICAL pathology; HISTOLOGICAL techniques; LIPIDS; MICROSCOPY; MYCOBACTERIUM; POLYMERASE chain reaction; RISK assessment; SERODIAGNOSIS; TREATMENT effectiveness; TREATMENT duration
- Publication
Infection, 2019, Vol 47, Issue 6, p1065
- ISSN
0300-8126
- Publication type
Article
- DOI
10.1007/s15010-019-01349-8