RESUMO
Leprosy is a chronic granulomatous disease involving the skin and nerves, leading to a debilitating condition. Leprosy has been controlled in most parts of the world; therefore physicians are not very well versed in the recognition, management and assessment of this disease. The protean manifestations of leprosy often lead to delays in diagnosis and increase the morbidity. We present a case of a 33-year-old male with fever, lymphadenopathy, nodular skin lesions, uveitis and arthritis. Lymphnode, bonemarrow and skin biopsy revealed 3+ AFB smear with negative AFB cultures, leading to the diagnosis of leprosy. The course of illness was complicated by flare of Erythema Nodosum Leprosum (ENL).
Assuntos
Eritema Nodoso/microbiologia , Febre/microbiologia , Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/diagnóstico , Adulto , Artrite/microbiologia , Doença Crônica , Humanos , Linfadenopatia/microbiologia , Masculino , Uveíte/microbiologiaAssuntos
Países em Desenvolvimento , Hanseníase , Mycobacterium leprae/isolamento & purificação , Úvea/microbiologia , Uveíte , Diagnóstico Diferencial , Humanos , Incidência , Hanseníase/diagnóstico , Hanseníase/epidemiologia , Hanseníase/microbiologia , Uveíte/diagnóstico , Uveíte/epidemiologia , Uveíte/microbiologiaRESUMO
The study was carried out in Meshed, Islamic Republic of Iran, from 1998 to 2000 to explore the visual outcome of eye surgery with extracapsular cataract extraction and intraocular lens replacement on 18 leprosy patients (20 eyes). The most common complications of leprosy were madarosis (90%) and partial or total corneal opacity (90%). Visual acuity before surgery ranged from 'light perception' to 1/10, and this improved after surgery to 5/10-8/10 for 55% of patients. Postoperative infection leading to endophthalmitis occurred in only 1 patient and was treated with drugs; this patient's visual acuity remained at 10 cm finger count. Posterior synechia due to chronic uveitis in leprosy was diagnosed in 70% of eyes, obstructed iris in 25%, keratic precipitates in 25% and moderate iris atrophia in 10%.
Assuntos
Extração de Catarata/métodos , Catarata , Implante de Lente Intraocular/métodos , Hanseníase/complicações , Idoso , Catarata/epidemiologia , Catarata/microbiologia , Extração de Catarata/efeitos adversos , Opacidade da Córnea/microbiologia , Ectrópio/microbiologia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Implante de Lente Intraocular/efeitos adversos , Hanseníase/epidemiologia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Uveíte/microbiologia , Acuidade VisualRESUMO
A Maltese immigrant presented with intermittent bilateral anterior uveitis for which no cause could be found. The inflammation did not respond to topical treatment and ultimately the left eye developed a hypopyon and was enucleated. Histological examination revealed granulomatous inflammation and large numbers of Mycobacterium leprae throughout the anterior segment. Occasional foci of inflammation containing Mycobacterium leprae were found in the vitreous extending to the retina at the posterior pole. These findings in the posterior segment have rarely been reported. Eye infection in Hansen's disease is frequent and delays in diagnosis are common.