01478nas a2200229   4500000000100000008004100001260002300042653001200065653003400077653003700111653001300148100001200161700001200173700001200185700001300197700001200210700001400222245005600236300000800292520092300300022002501223       2024                            d  bInforma UK Limited10aLeprosy10anasolacrimal duct obstruction10aendoscopic dacryocystorhinostomy10aepiphora1 aChen DA1 aRoth MT1 aSbeih F1 aFaquin W1 aYoon MK1 aMetson RB00aLeprosy as a cause of nasolacrimal duct obstruction  a1-43 a<p>Leprosy, also known as Hansen disease, is an airborne spread disease caused by&nbsp;<em>Mycobacterium leprae</em>&nbsp;(<em>M. leprae</em>) which commonly presents with skin lesions, peripheral neuropathy, and ocular involvement. This report describes a patient who presented with epiphora secondary to chronic nasolacrimal duct obstruction four years after completing antimicrobial treatment for tuberculoid leprosy. At the time of endoscopic dacryocystorhinostomy (DCR), the lacrimal sac demonstrated chronic dacryocystitis with granulomatous inflammation and a Fite positive staining bacterial rod-like structure. Pathological examination of the surgical specimen demonstrated numerous non-necrotizing granulomas in a perivascular and neural distribution, compatible with sequelae of previously treated&nbsp;<em>M. leprae</em>&nbsp;infection. The patient has remained symptom free six months after surgery.</p>
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