Leprosy: a case series and review.

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Dermatology

Background:

• Hansen disease, caused by Mycobacterium leprae, is historically known as leprosy.
• While rare in the US, it remains endemic in certain populations and can manifest years post-infection.
• US military personnel from endemic countries may be at risk.

Purpose of the Study:

• To highlight the diagnostic challenges and delays in Hansen disease cases within the US military.
• To emphasize the importance of early recognition and treatment of Hansen disease.
• To discuss the clinical presentation, diagnosis, classification, and treatment of Hansen disease.

Main Methods:

• Case series review of three US soldiers diagnosed with Hansen disease at Walter Reed Army Medical Center.
• Analysis of diagnostic timelines and initial misdiagnoses.
• Review of current literature on Hansen disease management.

Main Results:

• The mean time to diagnosis for the three soldiers was 8 months (range: 2-18 months).
• All three patients were initially misdiagnosed with other skin conditions, such as infections or contact dermatitis.
• Delayed diagnosis underscores challenges in recognizing Hansen disease in non-endemic settings.

Conclusions:

• Hansen disease requires a high index of suspicion, especially in at-risk populations like US military personnel from endemic regions.
• Prompt diagnosis and treatment are essential to prevent irreversible physical deformities and disabilities.
• Further education on Hansen disease presentation is needed for healthcare providers to avoid diagnostic delays.