01932nas a2200253   4500000000100000008004100001260001200042653001600054653001200070653002200082653001700104653002600121100001100147700001300158700001100171700001200182700001300194245010600207856008900313300001100402490000700413520124400420022001401664       2022                            d  c04/202210aCoinfection10aleprosy10asevere neuropathy10aTuberculosis10aType 2 lepra reaction1 aSami C1 aHassan S1 aKhan A1 aHasan M1 aArafat S00aA Young Female With Borderline Lepromatous Leprosy and Tuberculous Lymphadenitis: A Rare Coinfection.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9076034/pdf/cureus-0014-00000023892.pdf  ae238920 v143 a<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>
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