Cutaneous leprosy in Central Florida man with significant armadillo exposure

BMJ Case Rep. 2019 Jun 29;12(6):e229287. doi: 10.1136/bcr-2019-229287.

Abstract

Leprosy is a chronic infectious, granulomatous disease caused by the intracellular bacillus Mycobacterium leprae that infects macrophages and Schwann cells. While relatively rare in the USA, there is about 200 new cases of leprosy every year with the majority occurring in the southern parts of the country. It is believed to be linked to the region of the nine-banned armadillo in patients with no significant travel history outside of the country. In this case report, we encountered a 58-year-old Central Florida man that had extensive exposure to armadillos and presented with the typical symptoms of large erythaematous patches, numbness and peripheral nerve hypertrophy. Once diagnosed properly, patients are then reported to the National Hansen's Centre who provides the multidrug therapy for 12-24 months. Due to its rarity and its ability to mimic other more common ailments, leprosy should be included in the differential diagnosis in patients that have significant exposure to armadillos, live in the southern part of the country or have recently travelled to countries that have a high prevalence of leprosy.

Keywords: dermatological; dermatology; general practice/family medicine; infections; skin.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Armadillos / microbiology*
  • Diagnosis, Differential
  • Florida
  • Humans
  • Leprostatic Agents / therapeutic use
  • Leprosy, Lepromatous / diagnosis*
  • Leprosy, Lepromatous / drug therapy
  • Male
  • Middle Aged
  • Mycobacterium leprae / isolation & purification*
  • Rifampin / therapeutic use

Substances

  • Leprostatic Agents
  • Rifampin