title: Nerve abscess in primary neuritic leprosy.
abstract: 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.
authors.affiliation: Department of Neurology, King George Medical University, Uttar Pradesh, Lucknow, India.
authors.forename: Dheeraj
authors.initials: D
authors.lastname: Rai
authors.forename: Hardeep Singh
authors.initials: HS
authors.lastname: Malhotra
authors.forename: Ravindra Kumar
authors.initials: RK
authors.lastname: Garg
authors.forename: Madhu Mati
authors.initials: MM
authors.lastname: Goel
authors.forename: Kiran Preet
authors.initials: KP
authors.lastname: Malhotra
authors.forename: Vijay
authors.initials: V
authors.lastname: Kumar
authors.forename: Arun Kumar
authors.initials: AK
authors.lastname: Singh
authors.forename: Amita
authors.initials: A
authors.lastname: Jain
authors.forename: Neera
authors.initials: N
authors.lastname: Kohli
authors.forename: Shailesh Kumar
authors.initials: SK
authors.lastname: Singh
mesh_terms: D000038:Abscess / Q000382:microbiology* / Q000473:pathology; D000293:Adolescent; D006225:Hand / Q000294:innervation / Q000473:pathology; D006801:Humans; D007918:Leprosy / Q000150:complications* / Q000473:pathology; D015441:Leprosy, Tuberculoid / Q000150:complications* / Q000473:pathology; D008297:Male; D009443:Neuritis / Q000382:microbiology* / Q000473:pathology