Open AccessLeprosy-Related Chronic Arthritis with an Abundance of Mycobacterium Leprae in the Synovial Fluid: A Rare Case
Author(s) -
Hendra Gunawan,
Yuli Wulansari,
Pati Aji Achdiat,
Reti Hindritiani
Publication year - 2021
Publication title -
international medical case reports journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.198
H-Index - 11
ISSN - 1179-142X
DOI - 10.2147/imcrj.s312355
Subject(s) - medicine , leprosy , phalanx , mycobacterium leprae , carpal bones , dermatology , joint pain , interphalangeal joint , synovial fluid , carpal joint , arthritis , physical examination , surgery , pathology , osteoarthritis , radiography , wrist , alternative medicine
Bone and joint involvements are the most common manifestation in leprosy, after cutaneous and neurological manifestations, yet are underdiagnosed and rarely reported. We report a case of lepromatous leprosy in a 41-year-old male with bone and joint changes. Physical examination revealed a leonine face, madarosis, hypesthetic hypopigmented macules on the back, and swelling of fingers and toes. Acid-fast bacilli from slit-skin smear and synovial fluid in an interphalangeal joint of the hand were found. Radiographic features showed osteolysis and destruction of some phalanges of the hands, bone erosion and destruction of some phalanges of the feet, as well as destruction and subluxation of some hand joints. The patient was given multidrug therapy for multibacillary leprosy, resulting in the reduction of swelling in fingers and toes. In conclusion, the examination of bone and joint changes in leprosy patients is important for early detection and management of musculoskeletal complications, to prevent future deformities and disabilities.