title: Short report: Treatment failure in Hansen's disease.
abstract: Areas of low endemicity of Hansen's disease, such as Texas, California, and Hawaii, exist due to immigration and rare autochthonous infections. Managing this disease in these areas of low endemicity is difficult, especially in observing for relapse. The accurate diagnosis of relapse is imperative so that appropriate therapy can be promptly reinstituted and unnecessary treatment can be avoided. To assess treatment failures in an area of low endemicity, we retrospectively evaluated 113 patients with Hansen's disease treated in southern Texas. Of 57 patients who completed therapy, 11 were later restarted on medications for this disease for presumed relapse. However, nine of the 11 were found not to have true relapses of Hansen's disease. The accurate diagnosis of relapse of this disease is essential not only in the individual patient but also for prospective treatment trials to establish best practices.
authors.affiliation: Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas 78234-6200, USA. Clinton.Murray@AMEDD.ARMY.MIL
authors.forename: Clinton K
authors.initials: CK
authors.lastname: Murray
authors.forename: M Patricia
authors.initials: MP
authors.lastname: Joyce
authors.forename: Robert N
authors.initials: RN
authors.lastname: Longfield
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002991:Clofazimine / Q000008:administration & dosage; D003622:Dapsone / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007918:Leprosy / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology / Q000517:prevention & control; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012293:Rifampin / Q000008:administration & dosage; D013781:Texas / Q000453:epidemiology; D017211:Treatment Failure; D016312:Treatment Refusal
chemical_list: D003622:Dapsone; D002991:Clofazimine; D012293:Rifampin