02128nas a2200289   4500000000100000008004100001260004400042653002600086653001300112653002700125653000800152653004300160653001700203653003600220653003000256653003600286100002000322700001900342700001600361700001900377700001800396245013200414856008800546300000800634520118200642022001401824       2024                            d  bSpringer Science and Business Media LLC10aPure neuritic leprosy10aRifampin10aPulmonary Tuberculosis10aHIV10aNational leprosy eradication programme10aDulotegravir10aNational tb elimination program10a type 2 diabetes mellites10anational aids control programme1 aDeivasigamani M1 aSureshgraham D1 aSrikanth SP1 aSanthalingam B1 aChokalingam C00aTriple Infectious Syndrome: Pulmonary Tuberculosis and HIV in a Case of Pure Neuritic Leprosy With Underlying Diabetes Mellitus  uhttps://assets.cureus.com/uploads/case_report/pdf/271946/20240805-142632-z60mxq.pdf  a1-53 a<p>Pulmonary tuberculosis (PTB), human immunodeficiency virus (HIV), and leprosy are of public health importance, as all three diseases are communicable and contribute to disease burden in society. Coinfection with these three entities is extremely rare but leads to significant mortality and morbidity. We report a case that highlights the diagnostic challenges and therapeutic management of a patient who was diagnosed with pure neuritic leprosy on multibacillary-multidrug therapy (MB-MDT) and subsequently codiagnosed with PTB and HIV. The patient was started on anti-tubercular therapy and anti-retroviral therapy for treatment under India’s national health programs, which play a major role in treating those of low socioeconomic status. The optimization of these therapeutic drugs is quite challenging during treatment due to potential drug interactions and toxicities. High clinical suspicion is required to rule out PTB before initiating rifampicin-containing MB-MDT, which can lead to rifampicin-resistant TB and screening for HIV. As there is a social stigma associated with these patients, they require good psychological support during and after treatment.</p>
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