Clinico-bacteriological study was done in 51 leprosy patients below 14 years of age. Majority of the patients were males in the age group of 11 -14 years. Nearly 84% had not received any prior treatment because of lack of awareness and financial constraints. Only 11.76% had a positive contact history. Skin lesions were present in all cases and 84.3% had lesions mainly on the exposed areas of the body and their number was found to increase significantly with advancing age (p < 0.005). These lesions were hypo-pigmented patches in 88% cases. 88% of cases had hypo-anesthesia and nerve thickening was observed in 24% cases. The most common type of skin lesion was borderline tuberculoid (BT) in 53% cases. Positivity of the skin smears increased significantly as the number of the skin lesions per patient increased (p < 0.001). Multibacillary cases were seen in 15.6% of cases and found only in the age group of 10 -14 years of age. No statistically significant association between BCG vaccination and prevention of leprosy was seen.
Strongyloides stercoralis, an intestinal nematode, is the major causative agent of Strongyloidiasis in humans. In immunosuppressed patients, infection with S. stercoralis can lead to the syndrome of hyper infection, which can lead to serious condition in rare cases. For prompt diagnosis, early identification of larvae in the stool sample is helpful. The current case report depicts an instance of Strongyloidiasis in a patient with Hansen's infection. A 55-year-old elderly female patient reported with lepromatous infection and development of erythema nodosum leprosum and was undergoing treatment with thalidomide and prednisone for a decade. As the patient complained of vomiting and fever, a stool routine examination was done with saline and iodine mount which revealed plenty of rhabditiform larvae of S. stercoralis, identified by characteristic morphology. Early detection delays may be fatal and high levels of eosinophil might or may not always be elevated. She was treated with ivermectin (6 mg) in a double dose given 1 week apart which resulted in clearance of the larvae. The absence of infection was confirmed 3 times during follow-up by stool examination.
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