jueves, 21 de diciembre de 2017

Increasing Virulence in Leprosy Indicated by Global Mycobacterium spp. - Volume 24, Number 1—January 2018 - Emerging Infectious Disease journal - CDC

Increasing Virulence in Leprosy Indicated by Global Mycobacterium spp. - Volume 24, Number 1—January 2018 - Emerging Infectious Disease journal - CDC

Volume 24, Number 1—January 2018


Increasing Virulence in Leprosy Indicated by Global Mycobacterium spp.

To the Editor: The November 2017 issue of Emerging Infectious Diseases had 3 articles about leprosy, including these topics: a United States–born patient who tested positive for Mycobacterium lepromatosis (1); a lethal case of Mycobacterium leprae manifested as Lucio’s phenomenon in Peru (2); and pointing out that leprosy is an emerging disease in the eastern United States, including autochthonous cases without exposure to armadillos (3), which were previously shown to be a zoonotic source of transmission in the United States (4). Not only is leprosy not disappearing in the United States and globally, but the signs are pointing to a more virulent mycobacterial infection that is likely to be a microbial adaptation to the global use of multidrug therapy, as previously reported (5).
Lucio’s phenomenon is fortunately rare; there is no proven effective therapy for this type 3 reaction in leprosy patients. Historically, Lucio’s phenomenon was confined to Mexico, mostly in cases of diffuse lepromatous leprosy, also referred to as “Leprosy bonita.” In recent years, it has been discovered elsewhere, including the first known case in India in 2001 (6). Two additional cases of lethal Lucio’s leprosy were reported in 2 immigrants from Singapore to the United States, who were shown to have Mlepromatosis and M. leprae (7). The report of Levis et al. is likely confirmed by the recent discovery of Mlepromatosis and Lucio’s outside of Mexico (5).
In summary, leprosy is an emerging infection in the United States, including autochthonous cases in the eastern United States. The reports in the November issue of Emerging Infectious Diseases of autochthonous Mlepromatosis and a lethal case of Lucio’s phenomenon outside Mexico are ominous signs of a more virulent form of emerging leprosy.
William LevisComments to Author , Tina Rendini, and Frank Martiniuk
Author affiliations: Bellevue Hospital Center, New York, New York, USA (W. Levis, T. Rendini)JME Group, Roseland, New Jersey, USA (F. Martiniuk)


  1. Virk APritt BPatel RUhl JRBezalel SAGibson LEet al. Mycobacterium lepromatosis lepromatous leprosy in US citizen who traveled to disease-endemic areas. Emerg Infect Dis2017;23:18646DOIPubMed
  2. Ramal CCasapia MMarin JCelis JCBaldeon JVilcarromero Set al. Diffuse multibacillary leprosy of Lucio and Latapí with Lucio’s phenomenon, Peru. Emerg Infect Dis2017;23:192930DOIPubMed
  3. Rendini TLevis W<jrn>3. Rendini T, Levis W. Autochthonous leprosy without armadillo exposure, eastern United States. Emerg Infect Dis2017;23:1928DOIPubMed
  4. Sharma RSingh PLoughry WJLockhart JMInman WBDuthie MSet al. Zoonotic leprosy in the southeastern United States. Emerg Infect Dis2015;21:212734DOIPubMed
  5. Levis WRZhang SMartiniuk FMycobacterium lepromatosis: emerging strain or species? J Drugs Dermatol2012;11:158.PubMed
  6. Saoji VSalodkar ALucio leprosy with lucio phenomenon. Indian J Lepr2001;73:26772.PubMed
  7. Han XYSizer KCTan HHIdentification of the leprosy agent Mycobacterium lepromatosis in Singapore. J Drugs Dermatol2012;11:16872.PubMed
Cite This Article

DOI: 10.3201/eid2401.171785

No hay comentarios:

Publicar un comentario