麻风病和结核病是两种最古老和最常见的分枝杆菌感染,麻风分枝杆菌和麻风分枝杆菌引起的麻风病和结核分枝杆菌引起的结核病。双重感染自古以来就已经知道;然而,病例在文献中很少报道,即使在这两种疾病都流行的国家,比如马达加斯加。
■我们报告了一系列麻风病和结核病同时发生的病例。
■在这项回顾性研究中,我们回顾了在皮肤科注册的麻风患者的医疗记录,Befelatanana大学医院,塔那那利佛,马达加斯加,2012年1月至2021年6月。研究包括麻风病患者和被诊断为结核病合并感染的患者。
■在研究期间观察到的120例麻风病病例中,五名患者发现麻风病和结核病同时感染。平均年龄为43.4(SD13.2),21-59岁。男性占主导地位(4/5)。四名患者出现了麻风病,还有一个患有边缘麻风病。3例患者出现麻风反应。观察到4例肺结核和1例多灶性肺结核。4例麻风病的诊断先于肺结核,1例同时诊断为合并感染。结核病的平均发病时间为38.8(SD10.2)个月。HIV感染,营养不良,酒精消费,和长期皮质类固醇治疗是我们患者报告的免疫抑制因素。三名患者同时接受了麻风病和结核病的多种药物治疗。
皮肤科医生应意识到对麻风病患者进行潜伏性或活动性结核病筛查的重要性,以预防合并感染导致的发病率和死亡率,并降低对利福平的获得性耐药风险,这是这种联系的最大风险。
UNASSIGNED: Leprosy and tuberculosis are two of the oldest and most common mycobacterial infections, caused by Mycobacterium leprae and Mycobacteium lepramatosis for leprosy and Mycobacterium tuberculosis for tuberculosis. Dual infections have been known since ancient times; however, cases remain rarely reported in the literature, even in countries where both diseases are endemic, such as Madagascar.
UNASSIGNED: We report a
case series of simultaneous occurrence of leprosy and tuberculosis.
UNASSIGNED: In this retrospective study, we reviewed the medical records of patients with leprosy registered at the Department of Dermatology, University Hospital Befelatanana, Antananarivo, Madagascar, between January 2012 and June 2021. Patients with leprosy and diagnosed as coinfected by tuberculosis were included in the study.
UNASSIGNED: Of the 120 leprosy cases observed during the study period, coinfection with leprosy and tuberculosis was found in five patients. The mean age was 43.4 (SD 13.2) ranging, 21-59 years. Male gender was predominant (4/5). Four patients presented with lepromatous leprosy, and one with borderline lepromatous leprosy. Three patients experienced leprosy reaction. Four cases of pulmonary tuberculosis and one
case of multifocal tuberculosis were observed. The diagnosis of leprosy preceded tuberculosis in four cases, and a coinfection diagnosis was made simultaneously in one
case. The average time to develop tuberculosis was 38.8 (SD 10.2) months. HIV infection, malnutrition, alcohol consumption, and long-term corticosteroid therapy were the immunosuppressive factors reported in our patients. Three patients received concomitant multidrug therapy for leprosy and tuberculosis.
UNASSIGNED: Dermatologists should be aware of the importance of screening patients affected by leprosy for latent or active tuberculosis to prevent morbidity and mortality due to coinfection and to reduce the risk of acquired resistance to
rifampicin, which is the greatest risk of this association.