{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:26:47Z","timestamp":1767677207526},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T00:00:00Z","timestamp":1662508800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Ann Clin Microbiol Antimicrob"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Leprosy is a chronic infectious disease caused by <jats:italic>Mycobacterium leprae<\/jats:italic> or <jats:italic>Mycobacterium lepromatosis<\/jats:italic> that is mainly transmitted through droplets from the nose and mouth of untreated patients. Owing to the lack of specific serological markers and clinical manifestations, leprosy can be easily confused with other skin lesion-related diseases and is difficult to distinguish.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>This study introduces and summarises the diagnosis and treatment process of a case of leprosy misdiagnosed as erythema multiforme for a long time. A 43-year-old female was admitted to our hospital because of \u201crepeated fever with superficial lymphadenopathy and systemic rash in May\u201d. The diagnosis of the patient was based on the two main clinical characteristics of superficial lymphadenopathy and systemic pleomorphic erythema by using a combination of multiple samples of lymph nodes and skin, routine pathological examination, immunohistochemistry, acid-fast, silver hexamine, periodic acid-Schiff (PAS) staining, and second-generation gene sequencing of fresh biopsy tissue. The patient was treated with dapsone, rifampicin, and clofazimine at the Institute of Dermatology and Venereal Diseases. After treatment for 1\u00a0year, her temperature returned to normal, the area of facial erythema decreased, and the volume of axillary lymph nodes had gradually reduced.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In conclusion, special pathological staining and second-generation gene sequencing show promising advantages in distinguishing leprosy from other skin lesion-related diseases.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12941-022-00532-4","type":"journal-article","created":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T14:02:42Z","timestamp":1662559362000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Next-generation sequencing-assisted diagnosis of a case of leprosy misdiagnosed as erythema multiforme"],"prefix":"10.1186","volume":"21","author":[{"given":"Yanfang","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuezhong","family":"Lei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajie","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,7]]},"reference":[{"key":"532_CR1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciz1121","author":"R Sharma","year":"2020","unstructured":"Sharma R, Singh P, McCoy RC, Lenz SM, Donovan K, Ochoa MT, Estrada-Garcia I, Silva-Miranda M, Jurado-Santa Cruz F, Balagon MF, et al. Isolation of mycobacterium lepromatosis and development of molecular diagnostic assays to distinguish Mycobacterium leprae and M. lepromatosis. Clin Infect Dis. 2020. https:\/\/doi.org\/10.1093\/cid\/ciz1121.","journal-title":"Clin Infect Dis"},{"issue":"1","key":"532_CR2","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1128\/CMR.00079-13","volume":"28","author":"C White","year":"2015","unstructured":"White C, Franco-Paredes C. Leprosy in the 21st century. Clin Microbiol Rev. 2015;28(1):80\u201394.","journal-title":"Clin Microbiol Rev"},{"issue":"Suppl 3","key":"532_CR3","doi-asserted-by":"publisher","first-page":"e70","DOI":"10.1016\/j.ijid.2009.11.018","volume":"14","author":"V Budhiraja","year":"2010","unstructured":"Budhiraja V, Rastogi R, Khare S, Khare A, Krishna A. Histopathological changes in the arrector pili muscle of normal appearing skin in leprosy patients. Int J Infect Dis. 2010;14(Suppl 3):e70-72.","journal-title":"Int J Infect Dis"},{"issue":"4","key":"532_CR4","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1046\/j.1440-1711.2000.00939.x","volume":"78","author":"E Spierings","year":"2000","unstructured":"Spierings E, De Boer T, Zulianello L, Ottenhoff TH. Novel mechanisms in the immunopathogenesis of leprosy nerve damage: the role of Schwann cells, T cells and Mycobacterium leprae. Immunol Cell Biol. 2000;78(4):349\u201355.","journal-title":"Immunol Cell Biol"},{"issue":"2","key":"532_CR5","first-page":"81","volume":"25","author":"JA Dreisbach","year":"1954","unstructured":"Dreisbach JA. A case of leprosy in a seven months old child. Lepr Rev. 1954;25(2):81\u20132.","journal-title":"Lepr Rev"},{"issue":"4","key":"532_CR6","first-page":"379","volume":"55","author":"J Nsibambi","year":"1984","unstructured":"Nsibambi J, Berhan TY, Warndorff van Diepen T. Multibacillary leprosy in an 18-month-old child: a case report. Lepr Rev. 1984;55(4):379\u201383.","journal-title":"Lepr Rev"},{"issue":"7","key":"532_CR7","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1111\/jdv.15569","volume":"33","author":"W Alemu Belachew","year":"2019","unstructured":"Alemu Belachew W, Naafs B. Position statement: LEPROSY: diagnosis, treatment and follow-up. J Eur Acad Dermatol Venereol. 2019;33(7):1205\u201313.","journal-title":"J Eur Acad Dermatol Venereol"},{"issue":"1","key":"532_CR8","doi-asserted-by":"publisher","first-page":"48","DOI":"10.47276\/lr.77.1.48","volume":"77","author":"MI Bakker","year":"2006","unstructured":"Bakker MI, Hatta M, Kwenang A, Van Mosseveld P, Faber WR, Klatser PR, Oskam L. Risk factors for developing leprosy\u2014a population-based cohort study in Indonesia. Lepr Rev. 2006;77(1):48\u201361.","journal-title":"Lepr Rev"},{"issue":"1","key":"532_CR9","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.clindermatol.2015.10.016","volume":"34","author":"SK Noordeen","year":"2016","unstructured":"Noordeen SK. History of chemotherapy of leprosy. Clin Dermatol. 2016;34(1):32\u20136.","journal-title":"Clin Dermatol"},{"key":"532_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.actatropica.2020.105791","volume":"215","author":"K Neves","year":"2021","unstructured":"Neves K, Nobre ML, Machado LMG, Steinmann P, Ignotti E. Misdiagnosis of leprosy in Brazil in the period 2003\u20132017: spatial pattern and associated factors. Acta Trop. 2021;215: 105791.","journal-title":"Acta Trop"},{"issue":"8","key":"532_CR11","first-page":"1133","volume":"19","author":"R Alakad","year":"2021","unstructured":"Alakad R, Nofal A, Assaf M. Atypical presentations of erythema nodosum leprosum: diagnostic and therapeutic aspects. J Dtsch Dermatol Ges. 2021;19(8):1133\u201343.","journal-title":"J Dtsch Dermatol Ges"},{"issue":"5","key":"532_CR12","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1007\/s11606-021-06620-z","volume":"36","author":"B Woldemichael","year":"2021","unstructured":"Woldemichael B, Molla M, Aronowitz P. Erythema nodosum leprosum. J Gen Intern Med. 2021;36(5):1429\u201330.","journal-title":"J Gen Intern Med"},{"key":"532_CR13","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/s13104-015-1768-6","volume":"9","author":"H Aftab","year":"2016","unstructured":"Aftab H, Nielsen SD, Bygbjerg IC. Leprosy in denmark 1980\u20132010: a review of 15 cases. BMC Res Notes. 2016;9:10.","journal-title":"BMC Res Notes"},{"key":"532_CR14","doi-asserted-by":"publisher","DOI":"10.21276\/aimdr.2018.4.2.DE17","author":"S Awale","year":"2018","unstructured":"Awale S, Ranjan U, Darad P, Desai A. Erythema multiforme etiopathogenesis and treatment a review article. Ann Inter Med Dental Res. 2018. https:\/\/doi.org\/10.21276\/aimdr.2018.4.2.DE17.","journal-title":"Ann Inter Med Dental Res"},{"issue":"4","key":"532_CR15","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1016\/j.cden.2013.07.001","volume":"57","author":"F Samim","year":"2013","unstructured":"Samim F, Auluck A, Zed C, Williams PM. Erythema multiforme: a review of epidemiology, pathogenesis, clinical features, and treatment. Dent Clin North Am. 2013;57(4):583\u201396.","journal-title":"Dent Clin North Am"},{"issue":"3","key":"532_CR16","doi-asserted-by":"publisher","first-page":"285","DOI":"10.5025\/hansen.75.285","volume":"75","author":"Y Maeda","year":"2006","unstructured":"Maeda Y. Diagnosis of leprosy: serological aspects. Nihon Hansenbyo Gakkai Zasshi. 2006;75(3):285\u20139.","journal-title":"Nihon Hansenbyo Gakkai Zasshi"},{"issue":"8","key":"532_CR17","doi-asserted-by":"publisher","first-page":"e301","DOI":"10.1097\/RHU.0000000000001154","volume":"26","author":"RR Kumar","year":"2020","unstructured":"Kumar RR, Jha S, Dhooria A, Kapatia G, Dhir V. A case of leprosy misdiagnosed as lupus. J Clin Rheumatol. 2020;26(8):e301\u20132.","journal-title":"J Clin Rheumatol"},{"issue":"3","key":"532_CR18","first-page":"177","volume":"88","author":"KN Chowdhary","year":"2016","unstructured":"Chowdhary KN, Rao R, Priya P, Valiathan M, Shetty S, Pai S. Cutaneous sarcoidosis misdiagnosed as leprosy report of two cases and review of literature. Indian J Lepr. 2016;88(3):177\u201383.","journal-title":"Indian J Lepr"},{"key":"532_CR19","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1093\/oxfordjournals.epirev.a036245","volume":"4","author":"PE Fine","year":"1982","unstructured":"Fine PE. Leprosy: the epidemiology of a slow bacterium. Epidemiol Rev. 1982;4:161\u201388.","journal-title":"Epidemiol Rev"}],"container-title":["Annals of Clinical Microbiology and Antimicrobials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12941-022-00532-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12941-022-00532-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12941-022-00532-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,7]],"date-time":"2022-09-07T14:06:53Z","timestamp":1662559613000},"score":1,"resource":{"primary":{"URL":"https:\/\/ann-clinmicrob.biomedcentral.com\/articles\/10.1186\/s12941-022-00532-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,7]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["532"],"URL":"https:\/\/doi.org\/10.1186\/s12941-022-00532-4","relation":{},"ISSN":["1476-0711"],"issn-type":[{"value":"1476-0711","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,7]]},"assertion":[{"value":"9 May 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the ethics committee of West China Hospital of Sichuan University.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient and her spouse to publish this case report and any accompanying images. A copy of the written consent is available for review by the Editor in Chief of the journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The author declares that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"40"}}