Leprosy in the Upper Midwest.

INTRODUCTION: Leprosy is a life-threatening infection caused by Mycobacterium leprae with an average 5-year long incubation period. It is curable when treated early. Early diagnosis requires knowledge of its myriad clinical features as risk factors may not be readily apparent. CASE PRESENTATION: We report the case of a male patient from Wisconsin who tested positive for leprosy without a known exposure or recent travel to endemic areas. DISCUSSION: The clinical presentation of leprosy exists on a spectrum and correlates with cell immunity levels. The Ridley-Jopling and World Health Organization classifications are used to define leprosy subtypes and guide treatment. Histopathologic examination may aid in diagnosis of suspicious presentations. CONCLUSIONS: Leprosy may present with nonspecific clinical features and elevated inflammatory markers leading to a misdiagnosis. It should be considered on the differential diagnosis for suspicious presentations and appropriately worked up with various diagnostic modalities. A multidisciplinary approach to treatment may prevent spread and permanent damage.

[Doctor Eyvind Kraft--halfway around the world in the 1880s]. / Lege Eyvind Kraft--jorden halvveis rundt i 1880-årene.

More than every second Norwegian 19th century physician made one or more study trips abroad. Some of them were probably more inspired by love of adventure than by the prospect of gaining new medical insight. This was probably also true of my great-grandfather, Eyvind Kraft. Shortly after completing medical school in 1879, he left Norway on the "Musca", an emigrant vessel, bound for Hawaii. He returned home approximately six years later to establish a sanatorium. In the meantime he worked as a ship's doctor, made a contribution to the understanding of the contagiousness of leprosy, and was among the founding members of the first medical society in the state of Wisconsin. Back in Norway he worked at the sanatorium, but also as a general practitioner and among fishermen during the seasonal fisheries. He had to travel to the Continent in an attempt to cure his "nerve disease". Eyvind Kraft's life tells an exciting story of exotic places and of the view of disease in his time.