Diagnostic Pitfalls in an Atypical Case of Primary Neuritic Leprosy

2021 ◽  
Author(s):  
Winnie Ooi ◽  
Shrein Saini
Keyword(s):  
Peripheral Nerves ◽  
Nerve Biopsy ◽  
Skin Lesions ◽  
Chain Reaction ◽  
Atypical Case ◽  
Delay In Diagnosis ◽  
Polymerase Chain ◽  
Histological Confirmation ◽  
High Resolution Ultrasonography ◽  
Diagnostic Pitfalls

Primary neuritic leprosy is a form of leprosy clinically limited to the peripheral nerves without obvious skin lesions. Diagnosing leprosy in the absence of typical dermatological features is challenging and often causes a delay in diagnosis. We describe a case of primary neuritic leprosy with atypical features and the roles that histological confirmation using nerve biopsy of an unenlarged nerve and newer techniques, such as polymerase chain reaction and high-resolution ultrasonography, play in improving the diagnosis.

scholarly journals Primary neural leprosy: systematic review

2013 ◽  
Vol 71 (6) ◽  
pp. 397-404 ◽  
Author(s):  
Jose Antonio Garbino ◽  
Wilson Marques Jr ◽  
Jaison Antonio Barreto ◽  
Carlos Otto Heise ◽  
Marcia Maria Jardim Rodrigues ◽  
...  
Keyword(s):  
Systematic Review ◽  
Scientific Evidence ◽  
Specific Treatment ◽  
Nerve Biopsy ◽  
Molecular Testing ◽  
Chain Reaction ◽  
Online Databases ◽  
Polymerase Chain ◽  
Definition Of ◽  
Based Medicine

The authors proposed a systematic review on the current concepts of primary neural leprosy by consulting the following online databases: MEDLINE, Lilacs/SciELO, and Embase. Selected studies were classified based on the degree of recommendation and levels of scientific evidence according to the “Oxford Centre for Evidence-based Medicine”. The following aspects were reviewed: cutaneous clinical and laboratorial investigations, i.e. skin clinical exam, smears, and biopsy, and Mitsuda's reaction; neurological investigation (anamnesis, electromyography and nerve biopsy); serological investigation and molecular testing, i.e. serological testing for the detection of the phenolic glycolipid 1 (PGL-I) and the polymerase chain reaction (PCR); and treatment (classification criteria for the definition of specific treatment, steroid treatment, and cure criteria).

scholarly journals Human papillomavirus deoxyribonucleic acid may not be detected in non-genital benign papillomatous skin lesions by polymerase chain reaction

2014 ◽  
Vol 59 (4) ◽  
pp. 334 ◽  
Author(s):  
Davoodi Kaveh ◽  
Ayatollahi Hossein ◽  
Ghanadan Alireza ◽  
Damavandi Maede ◽  
Aghazadeh Nessa ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Human Papillomavirus ◽  
Deoxyribonucleic Acid ◽  
Skin Lesions ◽  
Chain Reaction ◽  
Polymerase Chain

Expression of the integrin alpha 6 beta 4 in peripheral nerves: localization in Schwann and perineural cells and different variants of the beta 4 subunit

1994 ◽  
Vol 107 (2) ◽  
pp. 543-552 ◽  
Author(s):  
C.M. Niessen ◽  
O. Cremona ◽  
H. Daams ◽  
S. Ferraresi ◽  
A. Sonnenberg ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Polymerase Chain Reaction ◽  
Nervous System ◽  
Peripheral Nerves ◽  
Northern Blot Analysis ◽  
The Other ◽  
Chain Reaction ◽  
The Central Nervous System ◽  
Polymerase Chain ◽  
Integrin Alpha 6

Integrin alpha 6 beta 4 is expressed in human peripheral nerves, but not in the central nervous system. This integrin heterodimer has previously been found in perineural fibroblast-like cells and in Schwann cells (SCs), which both assemble a basement membrane but do not form hemidesmosomes. We show here that in SCs, which had formed a myelin sheath, alpha 6 beta 4 was enriched in the proximity of the nucleus, at Ranvier paranodal areas and at Schmitt-Lanterman clefts; alpha 6 beta 4 was also found at the grooved interface between small axons and non-myelinating SCs. Immunoprecipitation of human peripheral nerves, in combination with Western blotting showed that beta 4 is associated with the alpha 6A subunit. Northern blot analysis of human peripheral nerves showed a single beta 4 transcript of 6 kb. Using the reverse transcriptase polymerase chain reaction, we detected two mRNA species, one for the most common (−70, -53) form of beta 4 and the other encoding the (+53) variant of beta 4. Cultured SCs were devoid of alpha 6 beta 4 but expressed alpha 6 beta 1, indicating that SCs lose beta 4 expression when contact with neurons is lost. Thus, resting SCs in contact with axons express alpha 6A in combination with beta 4, irrespective of myelin formation. We suggest that alpha 6 beta 4 expressed in SCs plays a role in peripheral neurogenesis.

Contagious ecthyma outbreak among goats at Nilgiri hills

2016 ◽  
Author(s):  
S. Balakrishnan ◽  
R. Venkataramanan ◽  
A. Ramesh ◽  
Parimal Roy
Keyword(s):  
Tamil Nadu ◽  
Viral Disease ◽  
Skin Lesions ◽  
Morbidity Rate ◽  
Vitamin B ◽  
Contagious Ecthyma ◽  
Chain Reaction ◽  
Agar Gel ◽  
Polymerase Chain ◽  
The Nilgiris

Contagious ecthyma is a highly contagious viral disease of sheep and goats, caused by Parapoxvirus. In the present outbreak over a range of 3 km radius in a hamlet near Ooty town in the Nilgiris hills, a total of 174 out of 194 non-descript goats were clinically affected with the symptoms of pyrexia (40°C), anorexia, depression, proliferative scab lesions on the skin around the mouth, oral commissures and nostrils. The morbidity rate was 89.7% without mortality. The symptoms were suggestive of contagious ecthyma. The disease was confirmed by agar gel immunodiffusion test, counter immunoelectrophoresis, and by polymerase chain reaction. Affected goats were treated with antibiotics, anti-pyretic, anti-inflammatory and vitamin B complex injections parenterally. Commercially available herbal topical spray (Topicure®) and/or neem leaf and turmeric paste was applied to alleviate the skin lesions. Affected goats were recovered in 4 to 5 weeks. This paper reports the first incidence of contagious ecthyma outbreak in goats during rainy season of the year in high altitude (the Nilgiri hills), Tamil Nadu.

Polymerase chain reaction for diagnosis of genital herpes: a missed opportunity?

2005 ◽  
Vol 16 (8) ◽  
pp. 579-581 ◽  
Author(s):  
E Agius ◽  
G Arthur ◽  
K Mandhyan ◽  
D Mercey
Keyword(s):  
Polymerase Chain Reaction ◽  
Tissue Culture ◽  
Herpes Simplex ◽  
Genital Herpes ◽  
Chain Reaction ◽  
Recurrent Genital Herpes ◽  
Delay In Diagnosis ◽  
Polymerase Chain ◽  
Simplex Virus ◽  
Missed Opportunity

This study audited the utilization of herpes simplex virus polymerase chain reaction (HSV PCR) in the investigation of recurrent anogenital ulceration at the Mortimer Market Centre. Clinic guidelines for use of HSV PCR were modified in April 2003 to expand PCR use. Ninety-six case-notes belonging to patients presenting with recurrent anogenital ulceration between 1 April and 16 October 2003 were reviewed and 59 were suitable for inclusion. Details of the investigations carried out at each visit were recorded. HSV PCR was used according to guidelines in eight of the 59 cases studied. This audit showed under-utilization of HSV PCR testing with poor adherence to clinic guidelines when cases of suspected recurrent genital herpes were investigated. This led to under-diagnosis and delay in diagnosis. This audit stresses the importance of informing all clinical staff of the improved sensitivity and relative affordability of HSV PCR compared with HSV tissue culture.

Sign in / Sign up

Export Citation Format

Share Document