1887

Abstract

Introduction. Leprosy is rarely reported in developed countries with low-prevalence settings. Its diagnosis may be missed due to its low frequency in non-endemic regions, as well as its long incubation period. The report describes an imported leprosy case of a healthcare worker in Singapore.

Case presentation. A Filipino nursing personnel presented with a persistent non-tender erythematous plaque over his right upper back for many years despite topical treatment. He had the lesion before coming to Singapore but decided to seek medical consultation only after the lesion progressed with new erythematous papules developing over his face, trunk and upper limbs. Punch biopsies of skin lesions revealed fite-positive bacilli, which were identified to be Mycobacterium leprae by GenoType LepraeDR v1 assay (Hain LifeScience, Germany). No mutation was detected at rpoB (rifampicin), gyrA (ofloxacin) and folP1 (dapsone) gene targets. He was started on multi-drug therapy and responded to the treatment. The only prolonged close contact he had was his housemate who was screened and given a single dose of rifampicin as chemoprophylaxis.

Conclusion. In non-endemic settings, awareness is crucial in diagnosing leprosy. The availability of molecular testing and multi-disciplinary management are essential in the confirmation and control of this disease of public health importance.

Loading

Article metrics loading...

/content/journal/acmi/10.1099/acmi.0.000014
2019-04-05
2019-08-23
Loading full text...

Full text loading...

/deliver/fulltext/acmi/1/3/acmi000014.html?itemId=/content/journal/acmi/10.1099/acmi.0.000014&mimeType=html&fmt=ahah

References

  1. World Health Organization Neglected tropical diseases. http://www.who.int/neglected_diseases/diseases/en/ 3 October 2018
  2. Fulton N, Anderson LF, Watson JM, Abubakar I. Leprosy in England and Wales 1953–2012: surveillance and challenges in low incidence countries. BMJ Open 2016;6:e010608 [CrossRef]
    [Google Scholar]
  3. World Health Organization Leprosy. http://www.who.int/news-room/fact-sheets/detail/leprosy 3 October 2018
  4. Communicable diseases surveillance in Singapore 2016 annual report. https://www.moh.gov.sg/resources-statistics/ 3 October 2018
  5. World Health Organization Weekly epidemiological record. 2011;86237–240
  6. Levis W, Rendini T, Martiniuk F. Increasing virulence in leprosy indicated by global Mycobacterium spp. Emerg Infect Dis 2018;24:183a–184 [CrossRef]
    [Google Scholar]
  7. Scollard DM, Adams LB, Gillis TP, Krahenbuhl JL, Truman RW et al. The continuing challenges of leprosy. Clin Microbiol Rev 2006;19:338–381 [CrossRef]
    [Google Scholar]
  8. Reja AH, Biswas N, Biswas S, Dasgupta S, Chowdhury IH et al. Fite-Faraco staining in combination with multiplex polymerase chain reaction: a new approach to leprosy diagnosis. Indian J Dermatol Venereol Leprol 2013;79:693–700 [CrossRef]
    [Google Scholar]
  9. Cambau E, Chauffour-Nevejans A, Tejmar-Kolar L, Matsuoka M, Jarlier V. Detection of antibiotic resistance in leprosy using genotype LepraeDR, a novel ready-to-use molecular test. PLoS Negl Trop Dis 2012;6:e1739 [CrossRef]
    [Google Scholar]
  10. GenoType LepraeDR ver 1.0 Germany: Hain LifeScience;Product insert
  11. Stefani MMA, Avanzi C, Bührer-Sékula S, Benjak A, Loiseau C et al. Whole genome sequencing distinguishes between relapse and reinfection in recurrent leprosy cases. PLoS Negl Trop Dis 2017;11:e0005598 [CrossRef]
    [Google Scholar]
  12. World Health Organization Guidelines for the diagnosis, treatment and prevention of leprosy. http://www.who.int/neglected_diseases/news/WHO-to-publish-first-guidelines-on-leprosy-diagnosis/en/ 24 November 2018
http://instance.metastore.ingenta.com/content/journal/acmi/10.1099/acmi.0.000014
Loading
/content/journal/acmi/10.1099/acmi.0.000014
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error