01765nas a2200205   4500000000100000008004100001653002600042653002000068653000800088100001300096700001200109700001400121700001200135700001300147700001400160245009500174856012700269300000600396520115700402       2025                            d10aPure neuritic leprosy10aLymphadenopathy10aPNL1 aLuthra P1 aNikam B1 aHussain A1 aBhale G1 aPandey N1 aSinghal R00aPure Neuritic Leprosy Primarily Presenting with  Lymphadenopathy in Complex Lepra Reaction  uhttps://www.ijl.org.in/published-articles/26032025104651/9_Case_Report_Luthra_et_al_Jan_March_2025_final_print_version.pdf  a63 a<p>Leprosy, an infectious disease with multifaceted manifestations, often presents diagnostic challenges, particularly in atypical cases lacking characteristic skin lesions. Herein, we describe a rare case of pure neuritic leprosy (PNL) presenting with lymphadenopathy and fever, initially misdiagnosed as tuberculous lymphadenitis. A 20-year-old female exhibited bilateral painful inguinal lymphadenopathy, fever, and shooting forearm pain. Despite extensive diagnostic evaluations, including histopathological examination, the initial diagnosis remained elusive. Subsequent investigations, including nerve biopsy, revealed borderline tuberculoid leprosy with lymphadenopathy, highlighting the importance of considering leprosy in cases of fever and lymphadenopathy, even in the absence of typical skin manifestations. Early recognition and appropriate treatment are crucial to prevent complications and ensure optimal patient outcomes. This case underscores the necessity for heightened clinical suspicion and comprehensive evaluation to avoid diagnostic pitfalls and facilitate timely intervention in leprosy cases with atypical presentations.</p>