Leprosy-tuberculosis co-infection: A case series

Area of Science:

• Infectious Diseases
• Clinical Medicine
• Epidemiology

Background:

• Leprosy and tuberculosis (TB) share etiological and epidemiological similarities, including acid-fast bacteria, endemicity, and transmission routes.
• Despite shared characteristics, co-infection is unexpectedly infrequent, with fewer than 20 reported cases in the last decade.

Purpose of the Study:

• To investigate the clinical and epidemiological profile of patients diagnosed with both leprosy and TB co-infection.

Main Methods:

• A prospective, descriptive case series was conducted over 3 years at a tertiary care hospital.
• Data collected included patient demographics, leprosy type, TB type, diagnostic test results (slit skin smear, chest X-ray, IGRA, Mantoux), and treatment history.

Main Results:

• The study identified 20 patients with leprosy and TB co-infection (55% male, mean age 32.7 years).
• Lepromatous leprosy and type 2 lepra reaction were observed in half the patients. Pulmonary TB was most common (60%), with two cases of multidrug-resistant TB.
• TB was diagnosed first in 60% of cases, leprosy in 30%, and 10% were diagnosed concurrently.

Conclusions:

• Leprosy and TB co-infection presents significant diagnostic and treatment complexities, including challenges with drug resistance.
• There is a critical need for specific management guidelines to improve outcomes and reduce morbidity and mortality associated with these co-infections.
• Additional research is required to fully characterize the clinico-epidemiological parameters of leprosy and TB co-infection.