Case Report: Lepromatous Leprosy Masquerading as Acute Suppurative Lymphadenitis.

Leprosy is a chronic cutaneous infection. It is usually characterized by thickened nerves and maculo-anesthetic patches. Leprosy often has an unusual presentation, which is a diagnostic challenge. In this case report, we present a case of an elderly male who presented with fever and chronic pus-draining axillary, cervical, and inguinal lymph nodes. He also had a weak left foot for the previous 5 months. During his hospital stay, he developed additional papular lesions over his extremities. We performed fine needle aspiration from the lymph nodes and skin biopsy, which were suggestive of lepromatous leprosy. We initiated him on antileprosy medication. On follow-up, he was responsive to therapy. Although skin and nerve involvement in leprosy is common, this case had an atypical presentation of discharging lymph nodes.

Neuritic Hansen's disease: an unusual presentation and a diagnostic challenge on fine-needle aspirate.

Fine-needle aspiration cytology is now routinely used in the diagnosis of cervical lumps. We report on a case of leprous neuritis which presented as a cervical swelling. A diagnosis of leprosy was suggested on the basis of globi within histiocytes. These histiocytes differed from those classically described in leprosy. Retrospective review demonstrated the presence of occasional nerve fragments, and some of these closely resembled granulomas. The possible close resemblance of this lesion to tuberculosis and a histiocytic proliferative disorder is highlighted. Recognition of nerve fragments along with histiocytes should suggest the diagnosis.

Kikuchi's lymphadenitis in Qatar.

The clinicopathologic features of five cases of Kikuchi's lymphadenitis (histiocytic necrotizing lymphadenitis without granulocytic infiltration) occurring in Qatar are presented. There were three females and two males aged from 18 to 36 years with a mean of 29 years. Three were Indians and two were Qataris. Cervical lymph nodes were affected in all cases while one patient also had inguinal and femoral lymph node enlargement. Three patients achieved complete remission within three months. The differential diagnosis both clinically and histologically, included malignant lymphoma, toxoplasmosis, tuberculosis, leprosy, Yersinia and viral infections. To avoid errors in diagnosis, especially that of malignant lymphoma, attention must be paid to the location of the lesion, composition of the cellular infiltrate and the typical fibrinoid type of necrosis in the background.

Atypical mycobacterial cervical adenitis: clinical presentation.

Atypical mycobacterium cervical adenitis (AMCA) is a disease primarily of childhood and usually presents as a unilateral mass or draining sinus. The pathogens are mycobacteria which are distinct from Mycobacteria tuberculosis, leprae and bovis (the typical mycobacteria). The atypical mycobacteria are readily recovered from the environment and are generally of low virulence. They are increasingly being recognized as pathogen for man though they are probably not transmissible from human contact. Most commonly these organisms are implicated in either pulmonary disease or lymphadenopathy. Fourteen cases of AMCA occurring in childhood are presented. A review of the bacteriology of the atypical mycobacteria is included. The clinical presentation, differential diagnosis, chemotherapeutic management and role of surgical intervention are discussed.