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Leprosy in the emergency department
R J Hoffner1, V Esekogwu, W K Mallon
1Department of Emergency Medicine, University of Southern California School of Medicine, Los Angeles 90033, USA. hoffner1@hotmail.com
Summary
Emergency physicians can encounter leprosy patients in urban hospitals. Early recognition of leprosy symptoms is crucial for timely treatment and improved outcomes, despite documentation challenges.
Area of Science:
- Medical Science
- Public Health
- Infectious Diseases
Background:
- Urban hospitals serve diverse populations, including immigrants from leprosy-endemic regions.
- Emergency physicians (EPs) must be prepared to diagnose and manage leprosy cases.
- Leprosy, if untreated, can lead to severe, debilitating consequences.
Purpose of the Study:
- To review the emergency department (ED) course of leprosy patients.
- To describe common presenting patterns of leprosy in the ED.
- To aid EPs in recognizing new leprosy cases.
Main Methods:
- Retrospective chart review of patients in a Hansen's disease clinic.
- Data collected included demographics, leprosy type, ED presentations, and medications.
- Analysis of 118 ED visits by 74 patients.
Main Results:
- Most patients were of Mexican, Filipino, Vietnamese, and Chinese origin.
- Dermatologic (68%), neurologic (23%), and ophthalmologic (9%) complaints were most common ED presentations.
- Leprosy history was not elicited in 34% of patients; diagnosis was made in 20% of previously undiagnosed cases. Leprosy medications were often not documented.
Conclusions:
- Leprosy patients do present to U.S. EDs, and new cases can be identified.
- Early recognition is vital due to leprosy's severity and the benefits of multidrug therapy.
- Inconsistent documentation of leprosy history and medications may stem from patient stigmatization fears.