English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

### Learning point for cliniciansType II lepra reactions can occur after a long interval post therapy, which may span a decade as in this case. Skin lesions and lymphadenopathy can be the presenting features and would need careful exclusion of atypical mycobacterial infections. Modified Ziehl-Neelson stain is helpful in staining both these bacilli.A 35-years-old gentleman presented with continuous, moderate grade fever for 7 days preceded by multiple erythematous, papulonodular lesions on the thighs, face and trunk, along with enlarged, discrete, and tender, cervical and inguinal lymph nodes. (Figure 1a) The symptoms persisted despite intake of antihistaminics. There were no thickened nerves or hypoesthetic skin lesions. Figure 1. (a) Clinical photograph showing papular lesions over right arm. (b) Aspirate smear showing abundant polymorphs and foamy histiocytes (May Grunwald Giemsa stain, ×400). Inset shows numerous rod-shaped lepra bacilli in clusters and lying singly (arrow) (Modified ZN stain, …

ENL developing 10 years after leprosy treatment masquerading as atypical-mycobacterial infection