Paucibacillary leprosy presenting as fibular neuropathy: A case of autochthonous zoonotic exposure in endemic Florida

We report a case of paucibacillary leprosy presenting as fibular neuropathy in a patient from Florida, an area with documented autochthonous transmission of Mycobacterium leprae. The patient exhibited neuropathic symptoms and a characteristic skin lesion, ultimately confirmed by biopsy with histopathological findings consistent with paucibacillary Hansen's disease, with negative Fite-Faraco staining and negative M. leprae PCR. The patient reported no travel history to internationally endemic areas; zoonotic exposure through frequent contact with armadillo-inhabited soil was identified as the most probable source of infection. This case underscores the importance of thorough physical examination and consideration of autochthonous zoonotic exposure in regions with documented environmental transmission.