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Lepromatous leprosy masquerading as disseminated tuberculosis.
The American Journal of Medicine
|July 1, 1979
Summary
Leprosy can mimic disseminated tuberculosis, presenting with fever and pancytopenia. Early diagnosis is crucial, as this case highlights how lepromatous leprosy can be mistaken for tuberculosis.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Disseminated infections can present with non-specific symptoms like fever and pancytopenia.
- Tuberculosis (TB) is a common consideration in patients with disseminated disease, particularly those with acid-fast bacilli in bone marrow aspirates.
Observation:
- A 57-year-old man from Cuba presented with fever and pancytopenia.
- Bone marrow aspirate revealed numerous acid-fast bacilli, and liver biopsy showed granulomas.
- Initial treatment for presumed tuberculosis with isoniazid and rifampin led to temporary improvement, followed by relapse and worsening hematologic and hepatic function.
Findings:
- Failure to culture Mycobacterium tuberculosis despite initial findings suggestive of TB.
- A subsequent skin biopsy confirmed lepromatous leprosy.
- This case illustrates lepromatous leprosy masquerading as disseminated tuberculosis.
Implications:
- Clinicians should consider leprosy in the differential diagnosis of disseminated infections, especially when TB treatment fails or microbiological confirmation is lacking.
- Accurate diagnosis of leprosy is essential for appropriate treatment and to prevent severe complications.
- This case underscores the importance of comprehensive diagnostic evaluation in complex infectious disease presentations.