Abstract
In 2008, during an archaeological excavation on the medieval site of Montecorvino (Foggia, Puglia, Italy), ten individuals were found buried near the principal church. The tombs were dated to the 13th-14th centuries AD, except for one attributable to the 11th century AD. The individual from tomb MCV2 shows some bone changes in the rhinomaxillary area. The most probable diagnosis is that she suffered from a type of near-multibacillary leprosy. Although leprosy has been documented in Italy from the first millennium BC and well described in the first millennium AD, its presence seems to be confined to Northern and Central Italy. This is the first case of leprosy in southeastern Italy and the second in Southern Italy overall. At the moment, the interesting datum is that leprosy seems to appear in Southern Italy only after the first millennium AD. All this could be because of the First Crusade with the opening of new trade and pilgrimage routes to the Near East or simply because other cases of leprosy have still not been found in osteoarchaeological context.
Highlights
Leprosy, or Hansen’s disease, is a chronic infection caused by an unculturable pathogen, Mycobacterium leprae
The study of the pathological changes of the skeleton from the church at Montecorvino shows that this individual probably suffered from a type of near multibacillary leprosy
Specific bony changes are caused by invasion of the tissues by M. leprae, which is why facial changes are seen; secondary bone changes are a result of peripheral nerve involvement and lead to sensory nerve anaesthesia, trauma to the hands and feet because people cannot feel the trauma, ulceration of the feet and hands, secondary infection of the bones of the hands and feet [5]
Summary
Hansen’s disease, is a chronic infection caused by an unculturable pathogen, Mycobacterium leprae. It affects the peripheral nervous system primarily, especially the extremities (neural leprosy), and secondarily involves the skin, nasal tissues, and bones [1]. In its most severe form, multibacillary (MeSh-lepromatous) leprosy, both the skin lesions and the peripheral nerve damage become generalised and symmetrical in nature. Those with high immune status are more likely to develop paucibacillary (MeSh-tuberculoid) leprosy, where only a small number of skin lesions develop and peripheral nerve damage is asymmetrical. This decline probably may have been caused by the cross-infection between leprosy and tuberculosis [13,14,15], this possibility is debate still today and, the exact relationship between TB and leprosy still remains unclear [16]
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