Early Detection of Hansen's Disease in the Pediatric Population

Thought to be a disease only prevalent in third world countries, Hansen’s disease still prevails within the United States. Since 2015, there were 178 new cases of Hansen’s disease in the US, with the youngest patient 7 years of age. The largest proportion of cases are noted to be Asian or South Pacific Islander, as with our patient today.

In this case report, Patient was a 16-year-old female admitted for fever and rash. Patient had waxing and waning symptoms for 2 years. Prior to 2 years, patient was living on the island of Chuuk. Upon admission, patient was febrile on presentation. Labs were concerning for elevated WBC, CRP, and ESR. On presentation, patient had multiple skin lesions of different morphology. Patient was noted to have flesh-colored papules on chin, in addition to erythematous patches of nodules on all four extremities. Patient was started on Vancomycin and Ceftriaxone. Pediatric Infectious Disease was consulted who had initial concerns of Hansen’s disease and recommended biopsies of the lesions. Dermatology was consulted who performed biopsies of right forearm and left lower leg with pathology results confirming Mycobacterium Leprae. Patient was then established with the National Hansen’s Disease Foundation and started on series of blister medication packages. With close follow up with outpatient pediatric clinic, patient showed improvement of rash after starting her medication regimen.

In conclusion, Hansen’s disease is still prevalent in many parts of the country. It is important to consider in a differential diagnosis especially if patient has certain risk factors, unexplainable rash, and prolonged fever.