Concurrent pulmonary tuberculosis and lepromatous leprosy in a newly diagnosed HIV positive patient: a case report

BMC Pulmonary Medicine

Somasundram Pillay¹  Anisa Mosam²  Zamambo Mkhize³  Josiah T. Masuka⁴ 

[1] Department of Dermatology, Edendale Hospital, 89 Selby Msimang Rd, Pleissislaer, 3201, Pietermaritzburg, South Africa;Department of Internal Medicine, Nelson R Mandela School of Medicine, Private Bag X7, 4013, Congella, Durban, South Africa;Department of Dermatology, Nelson R Mandela School of Medicine, Private Bag X7, 4013, Congella, Durban, South Africa;Department of Dermatology, Nelson R Mandela School of Medicine, Private Bag X7, 4013, Congella, Durban, South Africa;Department of Dermatology, Edendale Hospital, 89 Selby Msimang Rd, Pleissislaer, 3201, Pietermaritzburg, South Africa;Department of Dermatology, Nelson R Mandela School of Medicine, Private Bag X7, 4013, Congella, Durban, South Africa;Department of Dermatology, Edendale Hospital, 89 Selby Msimang Rd, Pleissislaer, 3201, Pietermaritzburg, South Africa;Harare Central Hospital, PO Box ST14, Southerton, Harare, Zimbabwe;

关键词: Leprosy;    Pulmonary tuberculosis;    Syphilis;    HIV;    Coinfection;   

DOI  :  10.1186/s12890-021-01572-w

来源: Springer

【 摘 要 】

BackgroundThe leprosy-tuberculosis (TB) co-infection is rarely reported in recent times. However, this dual comorbidity is associated with high mortality and major morbidity. Unrecognised leprosy-TB co-infection may predispose affected patients to rifampicin monotherapy and subsequent drug resistance.Case presentationA 35 year old migrant, human immunodeficiency virus (HIV) positive male worker presented with 6 month history of symmetric infiltrative nodular plaques of the face and distal, upper extremities. A few days after initial dermatology presentation, a sputum positive pulmonary tuberculosis diagnosis was made at his base hospital. Subsequent dermatology investigations revealed histology confirmed lepromatous leprosy and a weakly reactive rapid plasma reagin test. The presenting clinical features and laboratory results were suggestive of lepromatous leprosy coexisting with pulmonary tuberculosis in an HIV positive patient.ConclusionsThis case illustrates the occurrence of leprosy with pulmonary tuberculosis in an HIV infected patient and the difficulties in interpreting non-treponemal syphilis tests in these patients. This case also highlights the need for a high index of suspicion for co-infection and the need to exclude PTB prior to initiation of rifampicin containing multi-drug therapy (MDT). Interdisciplinary management and social support are crucial in these patients.

【 授权许可】

CC BY