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Volume 29, Number 7—July 2023
Research

Systematic Review of Hansen Disease Attributed to Mycobacterium lepromatosis

Simon M. Collin, Amanda Lima, Stéfano Heringer, Vinícius Sanders, Hugo Aborghetti Pessotti, and Patrícia DepsComments to Author 
Author affiliation: Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil

Main Article

Table 1

Case reports and case series investigating Mycobacterium lepromatosis as a cause of Hansen disease (chronological by year of publication)*

Ref. YOP Patient
residence (origin)		 Patient age, y/sex Case description Specimen source PCR-confirmed infection Remarks
(1) 2008 USA (Mexico) 53/M DLL + LP Autopsy† M. lepromatosis Fatal. M. lepromatosis strain FJ924.
USA (Mexico)
 M/31
 DLL + LP
 Archive
 M. lepromatosis
 Fatal. Archived lymph node tissue (2002).
(16)
 2011
 Mexico
 F/86
 DLL + LP
 Archive
 M. lepromatosis
 Died at 3 mo. Strain Mx1-22 (100% identical with FJ924).
(17) 2012 Singapore M/61 DLL Archive Dual Fatal. Archived skin biopsy tissue (1999).
Singapore
 M/72
 DLL
 Archive
 Dual
 Fatal. Archived skin biopsy tissue (1999).
(18)
 2012
 Canada
 M/72
 Leprosy-like‡
 Current
patient§
 M. lepromatosis
 Died (lung cancer) at 5 mo. Some travel to Florida, no other risk factors.
(19) 2013 USA (Mexico) M/32 LL + ENL Archive M. lepromatosis Archived lymph node tissue (2005).
USA (Mexico)
 F/50
 DLL + LP
 Archive
 M. lepromatosis
 Archived lymph node tissue (1963).
(20)
 2015
 Mexico
 F/43
 DLL + ENL
 Current
patient
 M. lepromatosis
 Armadillo meat eaten in community but not by patient.
(22)
 2016
 Colombia
 F/37
 HIV+, LL + LP
 Archive
 M. leprae
 LP possible IRIS because of ART.
(23) 2016 USA (Mexico) M/25 BL + T1R >ENL¶ Archive M. lepromatosis Patient reported handling and eating armadillo in Mexico. Syphilis (borderline positive ANA).
USA (Mexico)
 F/41
 BL + ENL
 Current
patient
 M. lepromatosis
 Manifested 2012, sibling of 25 y M (2007 case), cohabited with brother for 12 mo after arrival in USA (2003).
(24)
 2016
 Mexico
 M/49
 DLL + ENL >LP¶
 Current
patient
 M. lepromatosis
 None
(25)
 2017
 USA (Mexico)
 M/31
 DLL + ENL
 Current
patient
 M. lepromatosis
 Patient reported hunting and eating armadillo in Mexico.
(13)
 2017
 USA
 M/59
 LL
 Current
patient#
 M. lepromatosis
 Rheumatoid arthritis for 2 y (prednisone + methotrexate).
(26) 2018 Myanmar M/68 LL Current
patient		 M. lepromatosis Patient had HD 20 y previously (treated with dapsone).
Myanmar
 M/24
 LL + ENL
 Current
patient
 M. lepromatosis
 BI 5+ at 24 mo, resistance suspected but no DRDR mutations.
(21)
 2019
 Indonesia
 F/41
 DLL + LP
 Current
patient
 Dual
 HD 28 y previous (treatment not reported).
(27)
 2020
 Paraguay
 F/21
 LL + ENL >LP¶
 Current
patient
 Dual
 Vasculitis had been suspected related to drug use.
(28)
 2020
 USA (Nepal)
 F/43
 BB + T1R >LP¶
 Current
patient
 M. leprae
 None
(15)
 2020
 Italy (Cuba)
 F/42
 DLL + LP
 Current
patient**
 M. lepromatosis
 Necrotic cutaneous vasculitis 4 y previous, partial resolution with corticosteroids.
(29)
 2020
 USA
 M/58
 LL + ENL
 Current
patient
 M. lepromatosis
 Patient had 12 y history of poor wound healing refractory to immunosuppressive treatment, connective tissue disease (scleroderma) and bilateral acro-osteolysis with amputated digits.
(30)
 2021
 Mexico
 F/32
 DLL + ENL
 Current
patient
 M. lepromatosis
 None
(31) 2022 DR M/40 LL Current
patient		 M. lepromatosis None
DR M/35 LL Current
patient		 Dual None
DR F/26 LL Current
patient		 Dual Detected as contact of a family case-patient, pregnant at time of diagnosis, MDT initiated after delivery.
DR M/48 BL Current
patient		 M. leprae Detected as contact of a family case-patient
DR (Haiti) M/27 LL Current
patient		 M. leprae Detected as contact of a family case-patient
DR
 F/39
 LL
 Current
patient
 M. leprae
 None
(9) 2022 Mexico M/27 DLL + LP Current
patient††		 M. lepromatosis ENL at 3 y treated with thalidomide. No regrowth of eyelashes or eyebrows. Alcoholism, drug, and solvent abuse.
Mexico
 F/49
 DLL
 Current
patient
 M. lepromatosis
 Follow up to 2021; no regrowth of eyelashes or eyebrows.
(11) 2022 USA M/51 DLL + LP Current
patient		 M. lepromatosis Acute kidney injury/glomerulonephritis

*ART, antiretroviral therapy; BB, midborderline (borderline borderline); BI, bacillary index; BL, borderline lepromatous; DLL, diffuse lepromatous; DR, Dominican Republic; ENL, erythema nodosum leprosum (type 2 reaction); IRIS, immune reconstitution inflammatory syndrome; LL, lepromatous; LP, Lucio’s phenomenon (erythema necroticans); MDT, multidrug therapy; ref., reference; T1R, type 1 reaction; YOP, year of publication. †First case identified as M. lepromatosis based on the 16S rRNA (strain FJ924) unique 19bp sequence TAATACTTAAACCTATTAA that compared poorly with the corresponding unique M. leprae 16bp sequence AAAAAATC—TTTTTTAG. ‡No bacilli detected in nerves. §Based on report by Han et al. (2008), 16S rRNA sequencing was repeated from archived specimens and found to match 100% with M. lepromatosis¶Right-arrow (>) indicates clinical progression or later development of reactional states. #One of 3 cases tested by PCR as described in a retrospective clinic review of 9 cases (the other 2 cases were M. leprae) (12). **One of 24 cases in Italy tested by PCR as described in a retrospective review of 55 cases (16 cases were M. leprae. 7 were PCR–negative) (23). ††Index case believed infected by grandfather (LL in 1993, age 60 y, died 2004); infected mother (PCR-confirmed M. lepromatosis), and sibling (BL in 2014, age 25 y, MDT 12 mo, cured and followed up to 2021).

Main Article

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Page created: May 22, 2023
Page updated: June 20, 2023
Page reviewed: June 20, 2023
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