LEPROSY
Leprosy Review
0305-7518
British Leprosy Relief Association
Colchester, UK
13-6140
0305-7518/13/064053+05
10.47276/lr.84.2.136
Original Papers
Nerve abscess in primary neuritic leprosy
RaiDheeraj
aGargRavindra Kumar
aGoelMadhu Mati
bMalhotraKiran Preet
cKumarVijay
dSinghArun Kumar
dJainAmita
eKohliNeera
fSinghShailesh Kumar
fa
Department of Neurology, King George Medical University, Uttar Pradesh, Lucknow, India
b
Department of Pathology, King George Medical University, Uttar Pradesh, Lucknow, India
c
Department of Pathology, Ram Manohar Lohiya Institute of Medical Sciences, Lucknow, India
d
Department of Plastic Surgery, King George Medical University, Uttar Pradesh, Lucknow, India
e
Department of Microbiology, King George Medical University, Uttar Pradesh, Lucknow, India
f
Department of Radiodiagnosis, King George Medical University, Uttar Pradesh, Lucknow, India
Correspondence to: Hardeep Singh Malhotra, Department of Neurology, King George’s Medical University, Lucknow-226003, India (Tele fax: +91 522 2258852; Mobile: +91 9559677084; e-mail: drhsmalhotra@gmail.com)
01062013
84
2
136
140
23042013
© Lepra
2013
Nerve abscess is an infrequently reported complication of leprosy. We describe a patient with a pure neuritic type of leprosy with multiple nerve abscesses, who presented with tingling and numbness in the medial aspect of his right forearm and hand. Subsequently he developed pain, redness and swelling over the medial side of his right elbow and the flexor aspect of his right wrist. High-resolution ultrasound showed diffuse thickening of the right ulnar nerve with hypoechoic texture housing a cystic lesion with internal debris suggesting an abscess, at the cubital tunnel. Histopathological examination of the pus and tissue obtained from the abscess revealed presence of granulomas with lepra bacilli. The patient responded to surgery and multidrug therapy. In conclusion, the nerve abscess as the first manifestation of leprosy is uncommon and a high index of suspicion is required to make a correct diagnosis.