Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient

Detalhes bibliográficos
Autor(a) principal: Santos, Luciene Silva dos
Data de Publicação: 2022
Outros Autores: Drummond, Marina Rovani, França, Andrea Fernandes Eloy da Costa, Pavan, Maria Helena Postal, Stelini, Rafael Fantelli, Cintra, Maria Letícia, Souza, Elemir Macedo de, Velho, Paulo Eduardo Neves Ferreira
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista do Instituto de Medicina Tropical de São Paulo
Texto Completo: https://www.revistas.usp.br/rimtsp/article/view/195257
Resumo: 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.
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spelling Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patientBartonellaCoinfectionLeprosyErythema nodosumAs 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.Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2022-05-16info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/19525710.1590/S1678-9946202264017Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e17Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e17Revista do Instituto de Medicina Tropical de São Paulo; v. 64 (2022); e171678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/195257/180423Copyright (c) 2022 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 Velhohttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessSantos, Luciene Silva dos Drummond, Marina Rovani França, Andrea Fernandes Eloy da Costa Pavan, Maria Helena Postal Stelini, Rafael Fantelli Cintra, Maria Letícia Souza, Elemir Macedo de Velho, Paulo Eduardo Neves Ferreira 2022-10-10T13:01:46Zoai:revistas.usp.br:article/195257Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:53:01.961599Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true
dc.title.none.fl_str_mv Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient
title Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient
spellingShingle Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient
Santos, Luciene Silva dos
Bartonella
Coinfection
Leprosy
Erythema nodosum
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
author Santos, Luciene Silva dos
author_facet Santos, Luciene Silva dos
Drummond, Marina Rovani
França, Andrea Fernandes Eloy da Costa
Pavan, Maria Helena Postal
Stelini, Rafael Fantelli
Cintra, Maria Letícia
Souza, Elemir Macedo de
Velho, Paulo Eduardo Neves Ferreira
author_role author
author2 Drummond, Marina Rovani
França, Andrea Fernandes Eloy da Costa
Pavan, Maria Helena Postal
Stelini, Rafael Fantelli
Cintra, Maria Letícia
Souza, Elemir Macedo de
Velho, Paulo Eduardo Neves Ferreira
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Santos, Luciene Silva dos
Drummond, Marina Rovani
França, Andrea Fernandes Eloy da Costa
Pavan, Maria Helena Postal
Stelini, Rafael Fantelli
Cintra, Maria Letícia
Souza, Elemir Macedo de
Velho, Paulo Eduardo Neves Ferreira
dc.subject.por.fl_str_mv Bartonella
Coinfection
Leprosy
Erythema nodosum
topic Bartonella
Coinfection
Leprosy
Erythema nodosum
description 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.
publishDate 2022
dc.date.none.fl_str_mv 2022-05-16
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://www.revistas.usp.br/rimtsp/article/view/195257
10.1590/S1678-9946202264017
url https://www.revistas.usp.br/rimtsp/article/view/195257
identifier_str_mv 10.1590/S1678-9946202264017
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://www.revistas.usp.br/rimtsp/article/view/195257/180423
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by-nc/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
publisher.none.fl_str_mv Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo
dc.source.none.fl_str_mv Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e17
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 64 (2022); e17
Revista do Instituto de Medicina Tropical de São Paulo; v. 64 (2022); e17
1678-9946
0036-4665
reponame:Revista do Instituto de Medicina Tropical de São Paulo
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instname_str Instituto de Medicina Tropical (IMT)
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institution IMT
reponame_str Revista do Instituto de Medicina Tropical de São Paulo
collection Revista do Instituto de Medicina Tropical de São Paulo
repository.name.fl_str_mv Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)
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