Leprosy case series in the emergency room: A warning sign for a challenging diagnosis

Leprosy can be considered a dissimulated disease, mainly when presented as atypical cases leading to mistaken diagnosis at the emergency setting. Herein we report six patients referred to the emergence room with hypotheses of acute myocardial infarction and arterial and venous thrombosis, although w...

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Bibliographic Details
Published inThe Brazilian journal of infectious diseases Vol. 25; no. 5; p. 1
Main Authors Bernardes-Filho, Fred, Lima, Filipe Rocha, Voltan, Glauber, de Paula, Natália Aparecida, Frade, Marco Andrey Cipriani
Format Journal Article
LanguageEnglish
Portuguese
Published Elsevier España, S.L.U 01.09.2021
Contexto
Elsevier
Brazilian Society of Infectious Diseases
Subjects
Case Report
Case studies
Diagnosis
Diagnostic errors
Emergency medicine
Emergency service
Hospitals
INFECTIOUS DISEASES
Leprosy
Neuritis
Peripheral nerves
Brazil
Leprosy
Neuritis
Emergency medicine
Peripheral nerves
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Summary:Leprosy can be considered a dissimulated disease, mainly when presented as atypical cases leading to mistaken diagnosis at the emergency setting. Herein we report six patients referred to the emergence room with hypotheses of acute myocardial infarction and arterial and venous thrombosis, although with chronic neurological symptoms; the seventh patient was referred with a wrong suspicion of infected skin ulcer. Positive findings included hypo-anesthetic skin lesions and thickened nerves; 100% were negative for IgM anti-phenolic glycolipid-I, while 71.4%, 100% and 42.8% were positive for IgA, IgM and IgG Mce1A. RLEP-PCR was positive in all patients. Ultrasound of peripheral nerves showed asymmetric and focal multiple mononeuropathy for all patients. Unfortunately, in many patients leprosy is often misdiagnosed as other medical conditions for long periods thus delaying initiation of specific treatment. This paper is intended to increase physicians’ awareness to recognize leprosy cases presented as both classical and unusual forms, including in emergency department.
ISSN:1413-8670
1678-4391
1678-4391
DOI:10.1016/j.bjid.2021.101634