A CASE OF SEPTIC SHOCK - ERYTHEMA NODOSUM LEPROSUM
Journal Title: Stanley Medical Journal - Year 2015, Vol 2, Issue 3
Abstract
Hansens Disease is one of the common treatable dermato-neurologic manifestations of a chronic granulomatous infectious disease. ENL or Type 2 Lepra reaction is an immune complex hypersensitivity phenomenon occurring in patients with polar or borderline lepromatous leprosy. It affects skin, peripheral nerves & mucous membranes. It follows initiation or completion of leprosy treatment in 90% of cases but can rarely precede treatment. This case describes a Lepra Reaction presenting with septic shock as a first manifestation even before treatment initiation. Patients may present with ENL as their first manifestation of leprosy which predominantly presents as crops of painful erythematous nodules and in severe cases it presents with fever, uveitis, arthritis, hypotension and tachycardia which mimics septic shock and can be lifethreatening. This case illustrates the importance of diagnosing an immune reaction in the setting of leprosy and clinical suspicion and recognition of this syndrome is critical to instituting appropriate therapy at early stage to prevent damaging effects.
Authors and Affiliations
Vinodkumar Radhakrishnan, Vasumathi G, Ramalingam A, Sujatha S. M
Keywords
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