@article{96911,
  keywords = {Coinfection, leprosy, severe neuropathy, Tuberculosis, Type 2 lepra reaction},
  author = {Sami C and Hassan S and Khan A and Hasan M and Arafat S},
  title = {A Young Female With Borderline Lepromatous Leprosy and Tuberculous Lymphadenitis: A Rare Coinfection.},
  abstract = {<p>In Bangladesh, tuberculosis and leprosy are endemic mycobacterial diseases; however, co-infection is rarely seen. Our patient had a high-grade fever, symmetrical polyarthritis, polymorphous erythematous lesions, widespread lymphadenopathy, peripheral neuropathy, bilaterally thickened ulnar nerves, and claw hands. A lymph node biopsy revealed tuberculosis having acid-fast bacilli with caseating epithelioid histiocytic granuloma. Cutaneous lesions and sural nerve biopsies indicated borderline lepromatous leprosy. Fite-Faraco stain showed the presence of lepra bacilli in the biopsied sural nerve. Mantoux test showed 15 mm induration in 72 hours. Nerve conduction study (NCS) showed severe sensory-motor polyneuropathy (axonal) of all four limbs. Prednisolone and thalidomide for severe type-2 lepra response and category-01 antituberculosis medication and multidrug therapy for multibacillary leprosy improved the patient's condition. Bacille Calmette-Guérin (BCG) vaccination in the community might protect against tuberculosis and leprosy, thus reducing such coinfection. However, reduced cell-mediated immunity might promote latent tuberculosis reactivation or super-infection in individuals with multi-bacilli illnesses.</p>
},
  year = {2022},
  journal = {Cureus},
  volume = {14},
  pages = {e23892},
  month = {04/2022},
  issn = {2168-8184},
  url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9076034/pdf/cureus-0014-00000023892.pdf},
  doi = {10.7759/cureus.23892},
  language = {eng},
}