(LML) Request for advice on HIV and Leprosy

Leprosy Mailing List – January 24,  2018

Ref.:   (LML)  Request for advice on HIV and Leprosy

From:  Ben Naafs, Munnekeburen, the Netherlands

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Dear Pieter,

To answer the request for advice from Tahir Dahiru, LML 22-01-2018, the following. Leprosy lesions can itch. HIV infection can lead to this aspect.

However, the smears should be positive. If they are not positive it could be that the bacilli were stained in a TB lab. The staining for TB is too strong for M. leprae. This the smear result is negative. In MB leprosy who have not gone through a stage of Tuberculoid or Borderline there may be no loss of sensation.  The enlargement of nerves points in the direction of leprosy. But when no sensory changes it is doubtful. To make a definite diagnosis you need 2 of the cardinal signs.

As a DD I would think of lymphoma, or diffuse Leishmaniasis. But the large nerves make me doubt.

 

With regards

 

Ben

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com