Work

Rifampicin and ofloxacin dual therapy as an adjunct to standard MB-MDT in the management of nodulo-ulcerative lepromatous leprosy with histoid-like features: a case report

Year: 2025

Type: article

Abstract: , remains an important public health issue in endemic regions despite ongoing elimination efforts. Histoid Hansen's disease, a variant of lepromatous leprosy, is characterised by shiny, well-defined nodules and a heavy acid-fast bacillary load. We present a case of a 50-year-old male agricultural worker from rural central India presenting during a community health camp with multiple cutaneous nodules clinically suggestive of histoid leprosy. Slit-skin-smears (SSS) revealed abundant needle-shaped acid-fast bacilli, with numerous globi, whereas histopathological examination of a lesional biopsy supported the diagnosis of lepromatous leprosy (LL). This report presents a novel two-step treatment approach that is aimed at rapidly reducing infectivity using a 28-day course of rifampicin and ofloxacin (RO therapy), followed by initiation of multi-bacillary multidrug therapy (MB-MDT) to ensure sustained bacillary clearance. Repeat SSS demonstrated fragmented and granular acid-fast bacilli, indicating effective bactericidal activity. This case underscores the need for vigilant surveillance, early identification, and potential strategies to combat relapses and drug-resistant strains in the post-elimination era.

Source: Frontiers in Medicine

DOI: 10.3389/fmed.2025.1596617

Authors: Varun H, Adarshlata Singh, Bhushan Madke, Anurag Mittal

Institution: Datta Meghe Institute of Higher Education and Research

Language: English

Topic: Leprosy Research and Treatment

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801