Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient
ABSTRACT As leprosy and leprosy reactions are the most prevalent infectious cause of physical disability, it is important to commit efforts to better understand these chronic reactions. Infections, even when asymptomatic, can trigger leprosy reactions and Bartonella spp. in turn, can cause chronic i...
Published in: | Revista do Instituto de Medicina Tropical de São Paulo |
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Universidade de São Paulo (USP)
2022
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Online Access: | https://doi.org/10.1590/s1678-9946202264017 https://doaj.org/article/a78ae3e4f98c48b582001f61964bc14f |
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ftdoajarticles:oai:doaj.org/article:a78ae3e4f98c48b582001f61964bc14f 2024-09-09T19:28:07+00:00 Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient Luciene Silva dos Santos Marina Rovani Drummond Andrea Fernandes Eloy da Costa França Maria Helena Postal Pavan Rafael Fantelli Stelini Maria Letícia Cintra Elemir Macedo de Souza Paulo Eduardo Neves Ferreira Velho 2022-02-01T00:00:00Z https://doi.org/10.1590/s1678-9946202264017 https://doaj.org/article/a78ae3e4f98c48b582001f61964bc14f EN eng Universidade de São Paulo (USP) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652022000100505&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202264017 https://doaj.org/article/a78ae3e4f98c48b582001f61964bc14f Revista do Instituto de Medicina Tropical de São Paulo, Vol 64 (2022) Bartonella Coinfection Leprosy Erythema nodosum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2022 ftdoajarticles https://doi.org/10.1590/s1678-9946202264017 2024-08-05T17:49:31Z ABSTRACT As leprosy and leprosy reactions are the most prevalent infectious cause of physical disability, it is important to commit efforts to better understand these chronic reactions. Infections, even when asymptomatic, can trigger leprosy reactions and Bartonella spp. in turn, can cause chronic infections. We presented a case of a 51-year-old man who was admitted presenting with chronic type 2 leprosy reactions. He had a lepromatous form of leprosy that was histologically diagnosed six months after the onset of signs and symptoms compatible with a chronic type 2 reaction. He reported a history of a previous hepatitis B diagnosis. During a 24-month multidrug therapy (MDT), chronic reactions were partially controlled with prednisone and thalidomide. Thirty-three months following the leprosy treatment, he still experienced chronic reactions, and whole bacilli as well as globi were found on a new skin biopsy. Since coinfections can trigger type 2 reactions and the patient had close contact with animals and ticks, we investigated the presence of a Bartonella sp. infection. Bartonella henselae DNA was detected in a skin fragment obtained before the beginning of the leprosy retreatment. However, even after six months of a second leprosy MDT, he continued to experience type 2 chronic reactions. He was admitted to the hospital to undergo an intravenous antibiotic therapy for 14 days and then complete the treatment per os for ten more weeks. Leprosy reactions improved following the treatment for B. henselae. After completing the MDT treatment, he has been accompanied for sixty months with no signs of leprosy or leprosy reactions. The asymptomatic infection by B. henselaein this patient was considered the putative trigger of chronic leprosy reactions and leprosy relapse. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista do Instituto de Medicina Tropical de São Paulo 64 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
language |
English |
topic |
Bartonella Coinfection Leprosy Erythema nodosum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Bartonella Coinfection Leprosy Erythema nodosum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Luciene Silva dos Santos Marina Rovani Drummond Andrea Fernandes Eloy da Costa França Maria Helena Postal Pavan Rafael Fantelli Stelini Maria Letícia Cintra Elemir Macedo de Souza Paulo Eduardo Neves Ferreira Velho Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient |
topic_facet |
Bartonella Coinfection Leprosy Erythema nodosum Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
ABSTRACT As leprosy and leprosy reactions are the most prevalent infectious cause of physical disability, it is important to commit efforts to better understand these chronic reactions. Infections, even when asymptomatic, can trigger leprosy reactions and Bartonella spp. in turn, can cause chronic infections. We presented a case of a 51-year-old man who was admitted presenting with chronic type 2 leprosy reactions. He had a lepromatous form of leprosy that was histologically diagnosed six months after the onset of signs and symptoms compatible with a chronic type 2 reaction. He reported a history of a previous hepatitis B diagnosis. During a 24-month multidrug therapy (MDT), chronic reactions were partially controlled with prednisone and thalidomide. Thirty-three months following the leprosy treatment, he still experienced chronic reactions, and whole bacilli as well as globi were found on a new skin biopsy. Since coinfections can trigger type 2 reactions and the patient had close contact with animals and ticks, we investigated the presence of a Bartonella sp. infection. Bartonella henselae DNA was detected in a skin fragment obtained before the beginning of the leprosy retreatment. However, even after six months of a second leprosy MDT, he continued to experience type 2 chronic reactions. He was admitted to the hospital to undergo an intravenous antibiotic therapy for 14 days and then complete the treatment per os for ten more weeks. Leprosy reactions improved following the treatment for B. henselae. After completing the MDT treatment, he has been accompanied for sixty months with no signs of leprosy or leprosy reactions. The asymptomatic infection by B. henselaein this patient was considered the putative trigger of chronic leprosy reactions and leprosy relapse. |
format |
Article in Journal/Newspaper |
author |
Luciene Silva dos Santos Marina Rovani Drummond Andrea Fernandes Eloy da Costa França Maria Helena Postal Pavan Rafael Fantelli Stelini Maria Letícia Cintra Elemir Macedo de Souza Paulo Eduardo Neves Ferreira Velho |
author_facet |
Luciene Silva dos Santos Marina Rovani Drummond Andrea Fernandes Eloy da Costa França Maria Helena Postal Pavan Rafael Fantelli Stelini Maria Letícia Cintra Elemir Macedo de Souza Paulo Eduardo Neves Ferreira Velho |
author_sort |
Luciene Silva dos Santos |
title |
Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient |
title_short |
Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient |
title_full |
Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient |
title_fullStr |
Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient |
title_full_unstemmed |
Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient |
title_sort |
chronic type 2 reaction possibly triggered by an asymptomatic bartonella henselae infection in a leprosy patient |
publisher |
Universidade de São Paulo (USP) |
publishDate |
2022 |
url |
https://doi.org/10.1590/s1678-9946202264017 https://doaj.org/article/a78ae3e4f98c48b582001f61964bc14f |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Revista do Instituto de Medicina Tropical de São Paulo, Vol 64 (2022) |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652022000100505&tlng=en https://doaj.org/toc/1678-9946 1678-9946 doi:10.1590/s1678-9946202264017 https://doaj.org/article/a78ae3e4f98c48b582001f61964bc14f |
op_doi |
https://doi.org/10.1590/s1678-9946202264017 |
container_title |
Revista do Instituto de Medicina Tropical de São Paulo |
container_volume |
64 |
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