A CASE OF AFB NEGATIVE PURE NEURITIC LEPROSY : PRESENTED AS MONONEURITIS MULTIPLEX DIAGNOSED BY PCR - A CASE REPORT

Abstract

Pure Neuritic Leprosy, dened as a peripheral neuropathy in which the patient has no dermatological manifestation, is difcult to diagnose. Its diagnosis by bacteriological index and histopathology is not possible in the majority of the patient. Mononeuritis multiplex (MM) refers to involvement of several or many peripheral nerves at the same or different points in time by a disease process.This report describes a case of an atypical presentation of Hansen's disease (HD) as mononeuritis multiplex in the left lower limb and right upper limb with corresponding electrodiagnostic and molecular data that conrmed pure neuritic leprosy (PNL). The incidence of PNL is exceedingly low, still leprosy is the commonest cause of MM in the Indian subcontinent. It is important that the treating physician should also know the various neurological presentations, both mimics and chameleons, of this treatable disease to prevent permanent neuropathic injury and disability. Although Mononeuropathy is most common in PNL, the mononeuritis multiplex as the sole clinical presenting phenotype is quite uncommon. The case illustrated underscores the need to foster inter-speciality awareness because of the curable nature of the disease.