Atypical presentation of Hansen's disease, on the subject of a case

Abstract

Introduction. The chronic infectious disease leprosy, also called Hansen's disease, is caused by Mycobacterium leprae, an alcohol-acid-fast bacillus. It mainly affects the skin, peripheral nerves, the mucosa of the upper respiratory tract, the eyes and other structures. Clinical case. 58-year-old woman, in March 2018 she consulted for a progressive clinical picture dating from approximately 8 years characterized by: hypoesthesia, neuropathic pain of progressive course in the left upper limb, which does not give way with minor analgesics, having to do use of opioids; Gradual loss of movements, cramp, skin retraction, muscle atrophy of the upper and lower extremities and progressive loss of muscle strength, with hyporeflexia and dysesthesia, difficulty grasping and fine movements preventing their work activity, he refers temporary residence in endemic areas for Hansen's disease and Tuberculosis in Bolivia. Discussion and Conclusions. This is a particularly rare and different case, being that the bony presentation suggestive of tuberculous spondylitis in the spine has been observed in 2 anatomical sites C2-C3 and L5-S1 with corresponding motor and sensory functional affectation. The clinical polymorphism of the described case shows the unusual presentation in bone tissue and nerve involvement, the histopathology was compatible with Tuberculoid Leprosy, Leprotic neuropathy, responsible for the appearance of: Painful syndromes so severe in the patient. This case also translates into a problem for occupational public health, due to the complexity of the diagnosis and the barriers at the time of notification.