Coexistence of mycobacterial infections in a patient with Lucio phenomenon. Case report

Abstract

Leprosy is a chronic infectious disease, acquired by people susceptible to Mycobacterium leprae, with a neurodermatological predilection, with a high socio-health impact. In addition, it can include episodes of changes in the immune system, known as reactionary states, which includes the Lucio phenomenon, whose pathogenesis is poorly understood so far. Tuberculosis continues to be an endemic mycobacterial infection in Paraguay; however, co-infection with Mycobacterium Leprae is rarely seen. The transmission dynamics of both infections make the concomitant occurrence of Tuberculosis and Leprosy an infrequent phenomenon and the clinical symptoms of both diseases depend on the immune response of the host. We present a male patient who presents to the Internal Medicine service for a disseminated dermatosis of polymorphous appearance, with multiple disseminated scabrous and ulcerated erythemato-violet lesions of different types of sizes, associated with daily fever. A lymphocutaneous sample was taken at the level of the ear, which returned positive for Hansen's disease. The findings of the physical examination of the respiratory system revealed data suggestive of Pulmonary Tuberculosis, supported by the Computed Tomography report and the confirmation of the XPERT gene of sputum which returns positive for Mycobacterium Tuberculosis with sensitivity to rifampicin. Anti-tuberculosis medication and multidrug therapy for multibacillary leprosy substantially improved patient health. The relationship between the two mycobacterial diseases remains enigmatic despite decades of research, and case reports are of vital importance to the medical community.