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BMJ Case Rep ; 20182018 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-29545426


Leprosy and tuberculosis (TB) are endemic to India, however, their coinfection is not frequently encountered in clinical practice. Here, we report a 32-year-old female patient who presented with a history of high-grade intermittent fever, cough and painless skin lesions since a month, along with bilateral claw hand (on examination). The haematological profile was suggestive of anaemia of chronic disease, chest radiograph showed consolidation, sputum smears were positive for Mycobacterium tuberculosis, and skin slit smear confirmed leprosy. The patient was prescribed WHO recommended multidrug therapy for multibacillary leprosy with three drugs. Additionally, prednisolone was added to her regimen for 2 weeks to treat the type 2 lepra reaction. For treatment of TB, she was placed on the standard 6-month short course chemotherapy. She was lost to follow-up, and attempts were made to contact her. Later, it came to our notice that she had discontinued medications and passed away 3 months after diagnosis.

Hanseníase/diagnóstico , Tuberculose Pulmonar/diagnóstico , Adulto , Coinfecção , Tosse/etiologia , Diagnóstico Diferencial , Feminino , Febre/etiologia , Humanos , Índia , Hanseníase/complicações , Hanseníase/patologia , Radiografia Torácica , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico por imagem
Int J Lepr Other Mycobact Dis ; 55(3): 468-80, 1987 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-3655462


This study reports the results of field research on a leprosy epidemic among the Kapingamarangi people, Polynesians living in two communities on Ponape Island and Kapingamarangi Atoll in the Federated States of Micronesia. The patterns of infection in the two communities are seen to replicate in detail patterns of personal mobility by age and gender and patterns of kinship and friendship relations that order people's social interactions in the communities. These patterns of demographic and social relationship form the context of infectious contact, enabling us to differentiate between more- and less-probable means by which Hansen's disease is spread. We compare coughing and sneezing with inoculation through the frayed fibers of pandanus leaf floor mats and sleeping mats as alternative ways of spreading leprosy infection. We find that frayed mats, because they are ubiquitous in the contexts in which people interact, are more likely to spread infection than coughing and sneezing. Finally, we find that demographic patterns of the communities are not identical with genealogical relationships such that people with close genealogical relationships often do not interact on a regular basis. Thus, genealogical distance and social distance are independent of each other in this community. This makes genetic assessment of inheritance of resistance and susceptibility to Mycobacterium leprae an enterprise unencumbered by a necessarily linked demographic variable.

Surtos de Doenças , Relações Interpessoais , Hanseníase/epidemiologia , Adolescente , Adulto , Fatores Etários , Roupas de Cama, Mesa e Banho , Criança , Pré-Escolar , Tosse/complicações , Feminino , Habitação , Humanos , Lactente , Hanseníase/genética , Hanseníase/transmissão , Masculino , Micronésia , Pessoa de Meia-Idade , Fatores Sexuais , Espirro , Fatores Socioeconômicos
Int J Lepr Other Mycobact Dis ; 52(2): 171-5, 1984 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-6539310


Ten established cases of lepromatous leprosy with laryngeal involvement are reported, and their clinical and histopathological findings are discussed with a brief review of the literature.

Doenças da Laringe/patologia , Hanseníase/patologia , Adulto , Idoso , Cartilagem Aritenoide/patologia , Tosse , Epiglote/patologia , Feminino , Humanos , Laringoscopia , Laringe/patologia , Hansenostáticos/uso terapêutico , Hanseníase/complicações , Hanseníase/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Prega Vocal/patologia