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Tuberculoid leprosy diagnosed in Florida man who had trapped armadillos for researchers 30 yrs ago

Emily

Editor, Senior Moderator
Note that none of the usual leprosy tests were positive and the latency period is longer than expected.

https://casereports.bmj.com/content/12/6/e229287.full
Logas CM, Holloway KB
Cutaneous leprosy in Central Florida man with significant armadillo exposure
BMJ Case Reports CP 2019;12:e229287.

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.

View Full Text
http://dx.doi.org/10.1136/bcr-2019-229287

From full text:
On further history,
it was discovered that the patient used to trap and
sell armadillos for leprosy research approximately
30 years ago.

Despite the negative AFB culture
and negative PCR for M. leprae, based on the highly
suggestive pathology and clinical presentation
including the nerve hypertrophy and anaesthesia
of the lesion and after discussion with experts at
the National Hansens Center, the patient was diagnosed
clinically with tuberculoid leprosy.
 
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