A case of ENL complicated by a severe form of chicken pox

Leprosy Mailing List –  March 12^th, 2011

Ref:     A case of ENL complicated by a severe form of chicken pox.

From:  Salafia A, Mumbai , India

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Dear Salvatore,

I am really very grateful to all for the many (and prompt) suggestions. These are my update on my patient and a few further comments.

1.
Prof. Frankel: the patient is on a monthly dose of rifampicin.  The steroids given by us, where as 2mg/Kg/daily....

2.

Prof. Fine: yes, small pox was just a suspicion.  I repeat that about two months ago there was a news in the paper that in a remote village - somewhere in India - they had found a case of small pox; this is shocking because according to the Government of India small pox has been eradicated.

3.
The child, is still at Kasturba Hospital which is a Government hospital specialized in infectious diseases.

4.
The Doctor in charge confirmed, a few days ago, that it is a case of ENL but, complicated by a severe form of chicken pox; the child had developed signs of encephalitis (mentioned by Ben Naafs in his case).  She is now recovering.  The ENL reaction is under control too.

5.

They have administered to her some new antiviral drugs (very costly) but when she was admitted she was given lyophilised vaccine containing attenuated oka strain of varicella-zoster virus.  She is still in the hospital but she is recovering well.  

When she will come back to us, for continuing the management of ENL, I will have more news.

Thanks to you and to all.

Best wishes,

Antonio