Morbus Hansen (MH) Reinfection and Inappropriate Methylprednisolone Use

Wenly Susanto
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Abstract

Background: Morbus Hansen (MH), or leprosy, is a chronic granulomatous infection caused by Mycobacterium leprae. This disease still has a negative stigma, leading to ostracism. Methylprednisolone use can affect the risk of leprosy re-infection. Case: A 55-year-old female with complaints of abdominal pain, nausea, vomiting, and weakness accompanied by an active leprosy reaction. The patient had a history of leprosy treatment at the Sumenep Health Center in 2000 and at Sumberglagah Leprosy Hospital in 2004, but did not return for an acid-fast bacilli (BTA) check after therapy. She takes methylprednisolone 4 mg once or twice daily to manage an itch or rash. Her dermatological status was a symmetrical leprosy reaction throughout the body, accompanied by erythematous nodules and ulcerated nodules. Smear MH examination results +3 in indirect bacteriology and 25 bacteria in indirect microbiology. Treatment for multibacillary leprosy for 12–18 months and education were planned to increase patient awareness and compliance and appropriate steroid drug use.
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汉森氏菌(MH)再感染与甲基强的松龙的不当使用
背景:汉森氏麻风病(MH)或麻风病是由麻风分枝杆菌引起的慢性肉芽肿感染。这种疾病至今仍有负面的污名,导致人们排斥它。使用甲基强的松龙会影响麻风病再感染的风险。病例:一名 55 岁女性,主诉腹痛、恶心、呕吐和虚弱,并伴有麻风病活动反应。患者曾于2000年在苏美内普健康中心接受麻风病治疗,2004年在森巴格拉加麻风病医院接受麻风病治疗,但治疗后未再去医院检查耐酸杆菌(BTA)。她每天服用一到两次甲基强的松龙(4 毫克),以控制瘙痒或皮疹。她的皮肤状况为全身对称性麻风反应,伴有红斑结节和溃疡结节。MH 涂片检查结果为间接细菌学+3,间接微生物学检查结果为 25 个细菌。计划进行为期 12-18 个月的多脓疱麻风病治疗和教育,以提高患者的认识和依从性,并合理使用类固醇药物。
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