Pure neural leprosy in a child: case report and diagnostic challenges

Pure neural leprosy (PNL) is infrequent and manifests exclusively in the peripheral nerves without skin involvement, making the diagnosis more complex. We report the case of a 10-year-old child with muscle atrophy and sensory loss, diagnosed through clinical evaluation, grade 2 disability, and a positive anti-PGL-I test. The slit-skin smear (SSS) was negative for acid-fast bacilli. After 12 months of multidrug therapy, esthesiometric sensitivity improved; however, neurological deficits persisted, requiring anti-inflammatory treatment and physiotherapy. This case highlights the importance of early diagnosis and treatment for preventing disabilities. Tools, such as anti-PGL-I tests and imaging, are crucial, particularly in resource-limited settings.