An alternative multidrug regimen for multibacillary Hansen’s disease: a case report

Abstract Background Leprosy (Hansen’s disease) is an infectious disease most common in resource-limited countries caused by the acid-fast bacilli Mycobacterium leprae and Mycobacterium lepromatosis that frequently affects the skin and peripheral nerves. Prompt diagnosis and treatment with multidrug...

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Bibliographic Details
Main Authors: Nazar Akhverdyan, Zachary Cantor, Kellie Hawkins
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Journal of Medical Case Reports
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Online Access:https://doi.org/10.1186/s13256-024-04971-9
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Summary:Abstract Background Leprosy (Hansen’s disease) is an infectious disease most common in resource-limited countries caused by the acid-fast bacilli Mycobacterium leprae and Mycobacterium lepromatosis that frequently affects the skin and peripheral nerves. Prompt diagnosis and treatment with multidrug therapy is crucial to reduce disease transmission and sequelae, which include nerve function impairment, ocular injury, and stigmatizing physical deformities. Traditional treatment of multibacillary leprosy consists of 12–24 months of multidrug therapy with dapsone, rifampin, and clofazimine. However, this regimen is associated with high pill burden and side effects that limit adherence. Case presentation We report a case of multibacillary leprosy in a previously healthy 30-year-old Hispanic man who recently immigrated to the USA from South America and presented with progressive nodular skin lesions on his face and extremities. He was treated with a monthly regimen of rifampin, moxifloxacin, and minocycline. At follow-up there was significant improvement of his cutaneous lesions without signs of reversal reaction or erythema nodosum leprosum. Conclusions This case report adds to the growing repertoire of literature supporting the use of rifampin, moxifloxacin, and minocycline. Further studies are needed to assess the efficacy of this antimycobacterial regimen and monitor rates of relapse and delayed immunologic reactions, which may occur 5–10 years after completion of treatment.
ISSN:1752-1947