Abstract
Leprosy, or Hansen’s disease, is a chronic granulomatous disease caused by Mycobacterium leprae and the recently discovered Mycobacterium lepromatosis. In Spain and other countries, where leprosy has been eliminated, an increasing number of imported cases have been documented, especially from South Africa and South America. The diagnosis of leprosy is mainly clinical, based on the signs established by the World Health Organization (WHO), although laboratory tools can be useful for diagnostic confirmation. The treatment is based on the administration of multi-drug therapy, and involves the multidisciplinary work of experts in ophthalmology, orthopedics, and physiotherapy. We studied the confirmed cases by microbiological and /or histopathological diagnosis in the health area of Santiago de Compostela (456,874 inhabitants in Galicia, in the Northwest of Spain), analyzing their clinical, microbiological, and epidemiological characteristics (2006–2015). In our study, we describe five cases of leprosy, four of them imported and one that, in the absence of more data, is native. Although we have only documented five cases during the 10 years of the study, our experience highlights the importance of considering the country of origin, travel history, and contacts in patients or staff working with leprosy patients. Despite the decrease of leprosy in our environment, it is important to enhance suspicion of the disease among health personnel, especially in those patients from countries where leprosy is endemic and those in close contact with the diagnosed patients.
Similar content being viewed by others
References
Han XY, Seo Y-H, Sizer KC, Schoberle T, May GS, Spencer JS et al (2008) A new mycobacterium species causing diffuse lepromatous leprosy. Am J Clin Pathol 130(6):856–864. https://doi.org/10.1309/AJCPP72FJZZRRVMM
Eichelmann K, González SEG, Ocampo-candiani JCSJ (2013) Lepra : puesta al día . Definición , patogénesis , clasificación , diagnóstico y tratamiento. Actas Dermosifiliogr 104(7):554–563
Aslam S, Peraza J, Mekaiel A, Castro M, Casanas B (2019) Major risk factors for leprosy in a non-endemic area of the United States: a case series. IDCases 17:e00557 Available from : https://www.ncbi.nlm.nih.gov/pubmed/31193361
Monot M, Honoré N, Garnier T, Araoz R, Coppée J-Y, Lacroix C et al (2005) On the origin of leprosy. Science (80- ) 308(5724):1040 LP–1041042 Available from: http://science.sciencemag.org/content/308/5724/1040.abstract
Truman RW, Singh P, Sharma R, Busso P, Rougemont J, Paniz-Mondolfi A et al (2011) Probable zoonotic leprosy in the southern United States. N Engl J Med 364(17):1626–1633 Available from: https://www.ncbi.nlm.nih.gov/pubmed/21524213
Organización Mundial de la Salud. Estrategia mundial para la lepra 2016–2020 [Internet]. 2016. 70 p. Available from: http://apps.who.int/iris/bitstream/10665/208824/9/9789290225195-SPA.pdf?ua=1
Rodríguez E, Díaz O, Hernández G (2013) Vigilancia de la lepra en España en 2012 y situación mundial. Boletín epidemiológico Sem 21(1):1–4 Available from: http://revista.isciii.es/index.php/bes/article/view/779/887
Fleta ZJ (2001) Lepra: aspectos clínicos y tratamiento. Med Integr 38(7):309–314 Available from: https://www.elsevier.es/es-revista-medicina-integral-63-articulo-lepra-aspectos-clinicos-tratamiento-13022408
Leprosy [Internet]. Who.int. 2019 [cited 20 July 2019]. Available from: https://www.who.int/en/news-room/fact-sheets/detail/leprosy
[Internet]. 2019 [cited 21 July 2019]. Available from: https://apps.who.int/medicinedocs/es/d/Js5513s/3.html
Pérez del Molino ML, Barbeito-Castiñeiras G, Mejuto B, Alonso P, Fernández A, González-Mediero G et al (2016) The genotypic study of Mycobacterium tuberculosis complex resistant to isoniazid: Galicia, Spain (2008–2013). Eur J Clin Microbiol Infect Dis 35(11)
Costa-Alcalde JJ, Barbeito-Castiñeiras G, González-Alba JM, Aguilera A, Galán JC, Pérez-del-Molino ML (2019) Comparative evaluation of the identification of rapidly growing non-tuberculous mycobacteria by mass spectrometry (MALDI-TOF MS), GenoType Mycobacterium CM/AS assay and partial sequencing of the rpoβ gene with phylogenetic analysis as a reference method. Enferm Infecc Microbiol Clin 37(3):160–166 Available from: http://www.sciencedirect.com/science/article/pii/S0213005X18301873
Murray PR. Manual of clinical microbiology. 10th ed. Press A, editor. Washington, DC; 2011
Semwal S, Joshi D, Goel G, Asati D, Kapoor N (2018) Clinico-histological correlation in Hansen’s disease: three-year experience at a newly established tertiary care center in central India. Indian J Dermatol 63(6):465–468 Available from: https://www.ncbi.nlm.nih.gov/pubmed/30504973
Torres Guerrero E, Vargas Martínez F, Atoche Diéguez CE, Arrazola J, Arenas GR (2012) Lepra. Clasificación y cuadro clínico. Dermatol Rev Mex 56(4):47–54 Available from: https://www.medigraphic.com/pdfs/derrevmex/rmd-2012/rmd121g.pdf
Wolff K, Fitzpatrick T, Johnson R (2011) Atlas en color y sinopsis de dermatología clínica. McGraw-Hill Interamericana, Madrid
Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F et al (2007) An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med 175(4):367–416
Dirección Xeral de Saúde Pública. Informe da tuberculose en Galicia. Características dos casos de tuberculose de Galicia no ano 2017. Evolución do período 1996–2017 [monografía en internet]. Santiago de Compostela: Xunta de Galicia, Consellería de Sanidad. 2019; Available from: http://www.sergas.es/Saude-publica/Vixilanciaepidemioloxica-da-TB-en-Galicia
Soto A, Torres MP (2015) Leprosy diagnosis: an update on the use of molecular tools. Lucrecia Mol Biol 4(139)
Bezalel SA, Onajin O, Gonzalez-Santiago TM, Patel R, Pritt BS, Virk A et al (2019) Leprosy in a midwestern dermatology clinic: report of 9 patients. Mayo Clin Proc 94(3):417–423 Available from: http://www.sciencedirect.com/science/article/pii/S0025619618309376
Acknowledgments
Dr. JM Suárez Peñaranda, by Pathology Department of Santiago de Compostela, and Dr. JJ Palacios Gutiérrez, head of Reference Laboratory of Mycobacteria of Asturias (Spain).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All authors declare that they have no conflict of interest.
Ethical approval
The institutional research committee approved the present study.
Informed consent
Retrospective research, informed consent is not needed.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Barbeito-Castiñeiras, G., Mejuto, B., Nieto, A.C. et al. Leprosy in the twenty-first century: a microbiological, clinical, and epidemiological study in northwestern Spain. Eur J Clin Microbiol Infect Dis 39, 1831–1835 (2020). https://doi.org/10.1007/s10096-020-03911-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-020-03911-x