02943nas a2200289 4500000000100000008004100001260001200042653001500054653001500069653001500084100002100099700001900120700001600139700002000155700001700175700002200192700001700214700001400231700001900245700001400264245008300278856005500361300001400416490000700430520220200437022001402639 2024 d c01/202410aMadagascar10atratamento10aRifampicin1 aRakotoarisaona M1 aRazafimaharo T1 aSendrasoa F1 aAndrianarison M1 aRazanakoto N1 aRatovonjanahary V1 aRaharolahy O1 aRanaivo I1 aRamarozatovo L1 aRabenja F00aCoinfection with Leprosy and Tuberculosis: A Case Series in Malagasy Patients. uhttps://www.dovepress.com/getfile.php?fileID=98358 a1507-15130 v173 a

Background: Leprosy and tuberculosis are two of the oldest and most common mycobacterial infections, caused by Mycobacterium leprae and Mycobacteium lepramatosis for leprosy and Mycobacterium tuberculosis for tuberculosis. Dual infections have been known since ancient times; however, cases remain rarely reported in the literature, even in countries where both diseases are endemic, such as Madagascar.

Purpose: We report a case series of simultaneous occurrence of leprosy and tuberculosis.

Patients and Methods: In this retrospective study, we reviewed the medical records of patients with leprosy registered at the Department of Dermatology, University Hospital Befelatanana, Antananarivo, Madagascar, between January 2012 and June 2021. Patients with leprosy and diagnosed as coinfected by tuberculosis were included in the study.

Results: Of the 120 leprosy cases observed during the study period, coinfection with leprosy and tuberculosis was found in five patients. The mean age was 43.4 (SD 13.2) ranging, 21-59 years. Male gender was predominant (4/5). Four patients presented with lepromatous leprosy, and one with borderline lepromatous leprosy. Three patients experienced leprosy reaction. Four cases of pulmonary tuberculosis and one case of multifocal tuberculosis were observed. The diagnosis of leprosy preceded tuberculosis in four cases, and a coinfection diagnosis was made simultaneously in one case. The average time to develop tuberculosis was 38.8 (SD 10.2) months. HIV infection, malnutrition, alcohol consumption, and long-term corticosteroid therapy were the immunosuppressive factors reported in our patients. Three patients received concomitant multidrug therapy for leprosy and tuberculosis.

Conclusion: Dermatologists should be aware of the importance of screening patients affected by leprosy for latent or active tuberculosis to prevent morbidity and mortality due to coinfection and to reduce the risk of acquired resistance to rifampicin, which is the greatest risk of this association.

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