Infections and reactions in leprosy: a diagnostic dilemma

Leprosy (Hansen’s disease) is a chronic infectious disease caused by Mycobacterium leprae. It continues to be a public health problem in India, which contributes about 60% to the world leprosy burden. Leprosy patients when on treatment can develop either lepra reactions or reactions due to antileprosy drugs, also they can develop other infections endemic in their areas during the course of their disease. We are presenting such two cases where in one case patient on treatment with multibacillary multidrug therapy (MBMDT) developed fever, lympadenopathy and other systemic features during the course of therapy and was mistakenly diagnosed as type 2 lepra reaction but turned out to be a case of dapsone hypersensitivity. Similarly another case developed fever and other systemic features after 6 weeks of MBMDT, thinking it to dapsone syndrome his MBMDT pack was stopped but later it turned out to be a case of dengue.