Leprosy : a case report

Background: In 2004 World Health Organization reported 407.791 new cases and actually it is endemic only in some tropical and subtropical regions. Methods: A 14-year-old adopted Brazilian male, lived in Brazil from birth to 2002, was admitted to our Department of Pediatrics, University of Milan, Italy, for onset of erythematous and papular lesions on face, nose and ears, erythematous macules on arms, oedema of the wrists and back of the hands with pain and movement impairment and papular necrotic lesions symmetrically distributed on extremities. Lesions appeared 4 months prior to admission and were initially present on only the legs. Three months later, the patient started to present fever a loss of weight of about 4 kilograms. At the admission, patient presented dry skin, bilateral cervical and inguinal lymphadenopathy, hyperaemia of the pharynx, left epitasis and oedema of the nasal mucosa associated with a subjective sensation of nasal stuffiness. Haematological and cultural examinations, chest radiography, abdominal ultrasonography, chest and abdomen tomography, performed during the admission, resulted negative. A skin biopsy, which resulted positive for Mycobacterium Leprae, permitted the diagnosis of Lepromatous Leprosys. Conclusions Leprosy, also known as Hansen disease, is a slowly progressive, chronic granulomatous disease, principally affecting skin and peripheral nerves, caused by Mycobacterium Leprae. The diagnosis of Leprosy can be particularly difficult in no endemic regions: epidemiological, clinical and histological data are essential to formulate the diagnosis.