Leprosy is caused by Mycobacterium leprae, may mimic tuberculosis. We describe a 22year old woman with prolonged fever and cervical and inguinal lymphadenopathy. Initial lymph node aspirate from an outside centre showed acid fast bacilli on ZN staining using 20% sulfuric acid, leading to a diagnosis of tuberculosis and initiation of anti-tubercular therapy. Additionally, she developed ulcerative lesions over the feet after six weeks.At our centre,lesion pus revealed abundant AFB with differential decolorization. CBNAAT for tuberculosis was negative. Slit-skin smears, Fite Faraco stain and PCR confirmed multibacillary leprosy erythema nodosum leprosum. Multidrug therapy resulted in clinical improvement, highlighting diagnostic challenges.
BT - Indian journal of medical microbiology C1 - https://www.ncbi.nlm.nih.gov/pubmed/42570763 DA - 08/2026 DO - 10.1016/j.ijmmb.2026.101243 J2 - Indian J Med Microbiol LA - ENG M3 - Article N2 -Leprosy is caused by Mycobacterium leprae, may mimic tuberculosis. We describe a 22year old woman with prolonged fever and cervical and inguinal lymphadenopathy. Initial lymph node aspirate from an outside centre showed acid fast bacilli on ZN staining using 20% sulfuric acid, leading to a diagnosis of tuberculosis and initiation of anti-tubercular therapy. Additionally, she developed ulcerative lesions over the feet after six weeks.At our centre,lesion pus revealed abundant AFB with differential decolorization. CBNAAT for tuberculosis was negative. Slit-skin smears, Fite Faraco stain and PCR confirmed multibacillary leprosy erythema nodosum leprosum. Multidrug therapy resulted in clinical improvement, highlighting diagnostic challenges.
PY - 2026 T2 - Indian journal of medical microbiology TI - When a Mimicker Is Mimicked: A Case report on Acid-Fast Atypical Lepromatous Leprosy Mimicking Tuberculosis. SN - 1998-3646 ER -