02080nas a2200193   4500000000100000008004100001653001200042653001700054653004100071653002200112100001500134700001000149700000900159245007000168856003200238300000600270520159700276022001301873       2017                            d10aleprosy10aMisdiagnosis10aAdult onset Still’s disease (AOSD)10aCase presentation1 aShrestha B1 aLi YQ1 aFu P00aLeprosy mimics adult onset Still’s disease in a Chinese patient  uhttp://tinyurl.com/ybnbys6n  a43 a<p><strong>Background:</strong> Leprosy is an infectious disease that mainly involves the skin and peripheral nerves. It is caused by acid-fast, rod-shaped bacillus Mycobacterium leprae. In recent time, it has become a major global health concern which requires an early diagnosis and proper treatment in order to avoid lifelong neuropathy and disability. It is considered a ‘great mimicker’ as it exhibits a similar clinical features that resembles many connective tissue disease.<br />
<strong>Case presentation:</strong> We hereby describe a rare case of a 17-year-old-Chinese male referred to our hospital’s Rheumatology ward due to high grade fever of 40.3 °C, and painful erythematous nodules distributed over bilateral upper and lower limbs. He was previously misdiagnosed as adult onset Still’s disease (AOSD) and treated with immunosuppressive drugs. The diagnosis of borderline lepromatous leprosy with type-2 lepra reaction of was established on the basis of slit skin smear obtained from the lower right limb which showed few fragmented acid fast bacilli (AFB) by Ziehl-Neelsen staining. He was treated with multi drug therapy.<br />
<strong>Conclusion:</strong> The prevalence of leprosy is highly variable; as vast majority of cases are found in developing countries across the globe. Mycobacterium leprae often presents in a rheumatology clinic with a vivid array of clinical manifestations that are similar to various rheumatic diseases and often confuses rheumatologists. Rheumatologists should be aware of leprosy to avoid errors in diagnosis and treatment.</p>
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