Document Detail


Initial diagnosis of leprosy in patients treated by an ophthalmologist and confirmation by conventional analysis and polymerase chain reaction.
MedLine Citation:
PMID:  17532046     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report the initial diagnosis of leprosy in patients seeking treatment from an ophthalmologist in a tertiary eye care center, its confirmation by histopathologic and polymerase chain reaction analysis, and review of literature. DESIGN: Noncomparative retrospective case series. PARTICIPANTS: Patients with no known history of leprosy who were selected based on either a clinical suspicion or a histopathologic diagnosis and were found to have ocular or periocular lesions suggestive of leprosy. METHODS: Review of clinical records of patients with no known history of leprosy seen by an ophthalmologist at a tertiary eye care referral center. MAIN OUTCOME MEASURES: Patient demographics, presenting symptoms and signs, diagnostic studies, complications, and treatment. RESULTS: Among the 6 patients (5 women and 1 man; average age, 55 years), only 2 were found to have leprosy from clinical examination alone. Histopathologic characteristics or demonstration of acid-fast bacilli, suggestive of leprosy, were found in 5 patients. Definite confirmation of leprosy was made by polymerase chain reaction performed on formalin-fixed, paraffin-embedded tissues of 4 patients having suspected leprosy based on clinicohistopathologic examination results. CONCLUSIONS: The diagnosis of leprosy relies on the clinical symptom complex, epidemiologic factors, and demonstration of acid-fast bacilli in the tissue sample. Considering that the global leprosy population is 12 million, a patient with leprosy may be found anywhere. The ophthalmologist may be the first one to encounter such patient, in which case suspicion and detection of ocular findings may lead to early treatment of the infection. Polymerase chain reaction may be a new tool in the definite diagnosis of leprosy when suspicion of the diseases is raised by clinicohistopathologic studies.
Authors:
Imtiaz A Chaudhry; Farrukh A Shamsi; Elsanusi Elzaridi; Abdulaziz Awad; Hamad Al-Fraikh; Mohammed Al-Amry; Hassan Al-Dhibi; Fenwick C Riley
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Publication Detail:
Type:  Journal Article     Date:  2007-05-29
Journal Detail:
Title:  Ophthalmology     Volume:  114     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-02     Completed Date:  2007-10-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1904-11     Citation Subset:  IM    
Affiliation:
Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. orbitdr@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
DNA Primers / chemistry
DNA, Bacterial / analysis
Eye Infections, Bacterial / diagnosis*,  drug therapy,  microbiology
Female
Humans
Leprostatic Agents / therapeutic use
Leprosy / diagnosis*,  drug therapy,  microbiology
Male
Middle Aged
Mycobacterium leprae / genetics,  isolation & purification*
Ophthalmology
Polymerase Chain Reaction
Retrospective Studies
Chemical
Reg. No./Substance:
0/DNA Primers; 0/DNA, Bacterial; 0/Leprostatic Agents

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