Leprosy-Related Chronic Arthritis with an Abundance of Mycobacterium Leprae in the Synovial Fluid: A Rare Case

Hendra Gunawan, Yuli Wulansari, Pati Aji Achdiat, Reti Hindritiani Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran – Hasan Sadikin General Hospital, Bandung, West Java, 40161, IndonesiaCorrespondence: Hendra GunawanDepartment of Dermatology and Vener...

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Bibliographic Details
Main Authors: Gunawan H, Wulansari Y, Achdiat PA, Hindritiani R
Format: Article
Language:English
Published: Dove Medical Press 2021-06-01
Series:International Medical Case Reports Journal
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Online Access:https://www.dovepress.com/leprosy-related-chronic-arthritis-with-an-abundance-of-mycobacterium-l-peer-reviewed-fulltext-article-IMCRJ
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Summary:Hendra Gunawan, Yuli Wulansari, Pati Aji Achdiat, Reti Hindritiani Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran – Hasan Sadikin General Hospital, Bandung, West Java, 40161, IndonesiaCorrespondence: Hendra GunawanDepartment of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin General Hospital, Jl. Pasteur No. 38, Bandung, West Java, 40161, IndonesiaTel/Fax +62 22 2032426 Ext. 3449Email h.gunawan2016@unpad.ac.idAbstract: Bone and joint involvements are the most common manifestation in leprosy, after cutaneous and neurological manifestations, yet are underdiagnosed and rarely reported. We report a case of lepromatous leprosy in a 41-year-old male with bone and joint changes. Physical examination revealed a leonine face, madarosis, hypesthetic hypopigmented macules on the back, and swelling of fingers and toes. Acid-fast bacilli from slit-skin smear and synovial fluid in an interphalangeal joint of the hand were found. Radiographic features showed osteolysis and destruction of some phalanges of the hands, bone erosion and destruction of some phalanges of the feet, as well as destruction and subluxation of some hand joints. The patient was given multidrug therapy for multibacillary leprosy, resulting in the reduction of swelling in fingers and toes. In conclusion, the examination of bone and joint changes in leprosy patients is important for early detection and management of musculoskeletal complications, to prevent future deformities and disabilities.Keywords: bone, joint, leprosy, Mycobacterium leprae, synovial fluid
ISSN:1179-142X