Hanseníase dimorfa reativada: recidiva ou tratamento insuficiente em paciente imunologicamente suscetível?

Jaison Antonio Barreto; Flávio Goya; Rubem Mateus C Miranda

doi:10.47878/hi.2006.v31.36360

Authors

Jaison Antonio Barreto Diretor do Serviço de Epidemiologia do Instituto Lauro de Souza Lima.
Flávio Goya Instituto Lauro de Souza Lima
Rubem Mateus C Miranda Instituto Lauro de Souza Lima

DOI:

https://doi.org/10.47878/hi.2006.v31.36360

Keywords:

hanseníase dimorfa, recidiva, tratamento, reação de Mitsuda

Abstract

A 31 years old man looked for specialized health service due to sensibility changes in his left arm. Clinical examination confi rmed this complaint. Skin smears collected from the altered area did not show acid-fast bacilli. Mitsuda reaction was negative and a biopsy from the skin did not show any bacilli or infl ammatory process. The diagnosis was indeterminate (early) leprosy, and multidrugtherapy for paucibacillary leprosy was started. Nine years later, he returns with several lesions characteristics of borderline leprosy, which was confi rmed by skin biopsy and bacilloscopy of skin
smears. The previous treatment may have not destroy all the bacilli. In this situation remnant bacilli could have replicated, slowly and rogressively, reproducing the large period of incubation typical of individuals with negative Mitsuda reaction. Limitations of diagnosis based only in clinical features and in the lesions count criteria are discussed.

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