scholarly journals Mycobacterium lepromatosis as a Second Agent of Hansen’s Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Patrícia Deps ◽  
Simon M. Collin
Keyword(s):  
United States ◽  
Case Reports ◽  
The United States ◽  
Lepromatous Leprosy ◽  
Clinical Aspects ◽  
Red Squirrels ◽  
Hansen's Disease ◽  
Hansen’S Disease ◽  
Mycobacterium Lepromatosis

Mycobacterium lepromatosis was identified as a new species and second causal agent of Hansen’s disease (HD, or leprosy) in 2008, 150years after the disease was first attributed to Mycobacterium leprae. M. lepromatosis has been implicated in a small number of HD cases, and clinical aspects of HD caused by M. lepromatosis are poorly characterized. HD is a recognized zoonosis through transmission of M. leprae from armadillos, but the role of M. lepromatosis as a zoonotic agent of HD is unknown. M. lepromatosis was initially associated with diffuse lepromatous leprosy, but subsequent case reports and surveys have linked it to other forms of HD. HD caused by M. lepromatosis has been reported from three endemic countries: Brazil, Myanmar, and Philippines, and three non-endemic countries: Mexico, Malaysia, and United States. Contact with armadillos in Mexico was mentioned in 2/21 M. lepromatosis HD case reports since 2008. M. lepromatosis in animals has been investigated only in non-endemic countries, in squirrels and chipmunks in Europe, white-throated woodrats in Mexico, and armadillos in the United States. To date, there have only been a small number of positive findings in Eurasian red squirrels in Britain and Ireland. A single study of environmental samples found no M. lepromatosis in soil from a Scottish red squirrel habitat. Future studies must focus on endemic countries to determine the true proportion of HD cases caused by M. lepromatosis, and whether viable M. lepromatosis occurs in non-human sources.

Law Libraries of “The Last Frontier”

2004 ◽  
Vol 4 (4) ◽  
pp. 257-264
Keyword(s):  
United States ◽  
Growth And Development ◽  
Case Reports ◽  
The United States ◽  
State Court ◽  
History Of

This article by Cynthia Fellows describes the growth and development of Alaska's state court law libraries. To provide perspective, the first part of the article highlights the pre-statehood history of Alaska's laws and constitution. The second half describes general characteristics of court libraries in the United States, comments on U.S. case reports and computerised research, and traces the evolution of the Alaska state court libraries and the role of court librarians.

scholarly journals Delayed Diagnosis, Leprosy Reactions, and Nerve Injury Among Individuals With Hansen's Disease Seen at a United States Clinic

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Kristoffer E. Leon ◽  
Jesse T. Jacob ◽  
Carlos Franco-Paredes ◽  
Phyllis E. Kozarsky ◽  
Henry M. Wu ◽  
...  
Keyword(s):  
United States ◽  
Delayed Diagnosis ◽  
Retrospective Chart Review ◽  
The United States ◽  
Nerve Damage ◽  
Hansen's Disease ◽  
Delay In Diagnosis ◽  
Hansen’S Disease ◽  
Time Period ◽  
Delays In Diagnosis

Abstract Background.  Hansen's disease (HD), or leprosy, is uncommon in the United States. We sought to describe the characteristics of patients with HD in a US clinic, including an assessment of delays in diagnosis and HD reactions, which have both been associated with nerve damage. Methods.  A retrospective chart review was conducted on patients seen at an HD clinic in the southern United States between January 1, 2002 and January 31, 2014. Demographic and clinical characteristics were summarized, including delays in diagnosis, frequency of reactions, and other complications including peripheral neuropathy. Results.  Thirty patients were seen during the study time period. The majority of patients were male (73%) and had multibacillary disease (70%). Brazil, Mexico, and the United States were the most frequent of the 14 countries of origin. Hansen's disease “reactions”, severe inflammatory complications, were identified among 75% of patients, and nerve damage was present at diagnosis in 36% of patients. The median length of time between symptom onset and diagnosis was long at 12 months (range, 1–96), but no single factor was associated with a delay in diagnosis. Conclusions.  The diagnosis of HD was frequently delayed among patients referred to our US clinic. The high frequency of reactions and neuropathy at diagnosis suggests that further efforts at timely diagnosis and management of this often unrecognized disease is needed to prevent the long-term sequelae associated with irreversible nerve damage.

scholarly journals Pure neuritic leprosy presenting as ulnar nerve neuropathy: a case report of electrodiagnostic, radiographic, and histopathological findings

2015 ◽  
Vol 123 (5) ◽  
pp. 1238-1243 ◽  
Author(s):  
Russell Payne ◽  
Jennifer Baccon ◽  
John Dossett ◽  
David Scollard ◽  
Debra Byler ◽  
...  
Keyword(s):  
United States ◽  
Differential Diagnosis ◽  
Peripheral Neuropathy ◽  
Ulnar Nerve ◽  
The United States ◽  
Health Concern ◽  
Radiographic Evaluation ◽  
Causative Organism ◽  
Hansen's Disease ◽  
Hansen’S Disease

Hansen’s disease, or leprosy, is a chronic infectious disease with many manifestations. Though still a major health concern and leading cause of peripheral neuropathy in the developing world, it is rare in the United States, with only about 150 cases reported each year. Nevertheless, it is imperative that neurosurgeons consider it in the differential diagnosis of neuropathy. The causative organism is Mycobacterium leprae, which infects and damages Schwann cells in the peripheral nervous system, leading first to sensory and then to motor deficits. A rare presentation of Hansen’s disease is pure neuritic leprosy. It is characterized by nerve involvement without the characteristic cutaneous stigmata. The authors of this report describe a case of pure neuritic leprosy presenting as ulnar nerve neuropathy with corresponding radiographic, electrodiagnostic, and histopathological data. This 11-year-old, otherwise healthy male presented with progressive right-hand weakness and numbness with no cutaneous abnormalities. Physical examination and electrodiagnostic testing revealed findings consistent with a severe ulnar neuropathy at the elbow. Magnetic resonance imaging revealed diffuse thickening and enhancement of the ulnar nerve and narrowing at the cubital tunnel. The patient underwent ulnar nerve decompression with biopsy. Pathology revealed acid-fast organisms within the nerve, which was pathognomonic for Hansen’s disease. He was started on antibiotic therapy, and on follow-up he had improved strength and sensation in the ulnar nerve distribution. Pure neuritic leprosy, though rare in the United States, should be considered in the differential diagnosis of those presenting with peripheral neuropathy and a history of travel to leprosy-endemic areas. The long incubation period of M. leprae, the ability of leprosy to mimic other conditions, and the low sensitivity of serological tests make clinical, electrodiagnostic, and radiographic evaluation necessary for diagnosis. Prompt diagnosis and treatment is imperative to prevent permanent neurological injury.

Lepromin Skin Testing in the Classification of Hansen's Disease in the United States

1993 ◽  
Vol 305 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Wojciech A. Krotoski ◽  
Tomasz F. Mroczkowski ◽  
Thomas H. Rea ◽  
Pablo I. Almodovar ◽  
Bruce C. Clements ◽  
...  
Keyword(s):  
United States ◽  
Skin Testing ◽  
The United States ◽  
Hansen's Disease ◽  
Hansen’S Disease

scholarly journals Carville and Curupaiti: experiences of confinement and community

2003 ◽  
Vol 10 (suppl 1) ◽  
pp. 123-141 ◽  
Author(s):  
Cassandra White
Keyword(s):  
United States ◽  
Twentieth Century ◽  
The United States ◽  
Significant Problem ◽  
Outpatient Basis ◽  
Multidrug Therapy ◽  
Hansen's Disease ◽  
Hansen’S Disease ◽  
The World ◽  
History Of

Although Hansen's disease (leprosy) is still a significant problem in many parts of the world, the effectiveness of multidrug therapy has allowed people affected by this disease to be treated on an outpatient basis. However, throughout much of the twentieth century, people diagnosed with Hansen's disease were isolated from their families in facilities known as 'leprosaria'. This article presents a brief history of isolation policies and the development of community structures at two such facilities, Carville and Curupaiti, in the United States and Brazil, respectively. The modern dilemmas faced by the administration, staff, and residents of these institutions will also be discussed.

Hansen's disease in the United States

1982 ◽  
Vol 16 (9) ◽  
pp. 997-1004 ◽  
Author(s):  
Tim Hudson ◽  
Jim Genesse
Keyword(s):  
United States ◽  
The United States ◽  
Hansen's Disease ◽  
Hansen’S Disease

scholarly journals A 13-Year-Old with Coexistence of Gastric Volvulus and Leprosy: A Case Report of Two Rare Entities

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Joanna Schneider ◽  
Rhett Mays
Keyword(s):  
Gastric Volvulus ◽  
Outlet Obstruction ◽  
Skin Lesions ◽  
Lepromatous Leprosy ◽  
Marshall Islands ◽  
Hansen's Disease ◽  
Skin Changes ◽  
Hansen’S Disease ◽  
History Of

Leprosy, or Hansen’s disease, is caused by infection with Mycobacterium leprae. It is a rare diagnosis within the continental United States. We present the case of a 13-year-old immigrant from the Marshall Islands who presented with recurrent nausea, vomiting, and abdominal pain which are found to be due to intermittent gastric volvulus. Gastric volvulus is also exceedingly rare, with less than 8 pediatric cases on average per year. During her second hospitalization for recurrent acute gastrointestinal issues, nonspecific skin lesions were biopsied, revealing infection with M. leprae. The patient did not exhibit classic symptoms of leprosy but did have prominent skin changes including diffuse nodules. This case explores the pathophysiology connecting leprosy to volvulus, discussing the possible role of an inflammatory response to infection in causing gastric volvulus. The finding of lepromatous leprosy may have been unrelated but was fortuitous, as early intervention will result in avoidance of debilitating peripheral neuropathy and eventual disfiguration from Hansen’s disease. This case highlights the importance of considering rare causes of gastric outlet obstruction including gastric volvulus and of considering leprosy in the differential for patients with unusual skin lesions or paresthesias who have a history of living or traveling in endemic areas.

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