{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:11:41Z","timestamp":1780499501460,"version":"3.54.1"},"reference-count":48,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Mycobacterium lepromatosis<\/jats:italic>\n                    (\n                    <jats:italic>M. lepromatosis<\/jats:italic>\n                    ), first described in 2008 as another mycobacterial species that causes Hansen\u2019s disease, has mainly been reported in Mexico, Central America, and the southern United States; however, its disease spectrum and distribution remain unclear. A diagnostically challenging case that represents a likely autochthonous\n                    <jats:italic>M. lepromatosis<\/jats:italic>\n                    acquisition in the United States is reported in the present study. A 75-year-old immunocompetent man who had not traveled outside the Pacific Northwest developed an erythematous, ulcerating left thigh plaque, followed by three proximal sporotrichoid nodules. Biopsies revealed granulomatous inflammation with negative acid-fast stain results. Broad-range nontuberculous mycobacterial polymerase chain reaction testing identified\n                    <jats:italic>M. lepromatosis<\/jats:italic>\n                    in the sentinel ulcer and possible\n                    <jats:italic>Mycobacteroides chelonae<\/jats:italic>\n                    coinfection in the proximal nodule. The patient improved with multidrug therapy. Clinicians in the United States should keep Hansen\u2019s disease in the differential diagnosis, even for patients without international travel. Additional research is needed to clarify the phenotypic spectrum and geographic distribution of this pathogen.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.26-0034","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T18:08:59Z","timestamp":1776794939000},"page":"1078-1081","source":"Crossref","is-referenced-by-count":0,"title":["Probable Autochthonous Transmission of Mycobacterium lepromatosis in the Pacific Northwestern United States"],"prefix":"10.4269","volume":"114","author":[{"given":"Gregory S.","family":"Olson","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil J.","family":"Deveaux","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason D.","family":"Simmons","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Lieberman","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"1","key":"b1","series-title":"J Am Acad Dermatol","first-page":"1","article-title":"Leprosy: Clinical aspects and diagnostic techniques","volume":"83","author":"Maymone","year":"2020"},{"issue":"12","key":"b2","series-title":"Emerg Infect Dis","first-page":"2127","article-title":"Zoonotic leprosy in the southeastern United States","volume":"21","author":"Sharma","year":"2015"},{"issue":"17","key":"b3","series-title":"N Engl J Med","first-page":"1626","article-title":"Probable zoonotic leprosy in the southern United States","volume":"364","author":"Truman","year":"2011"},{"issue":"6313","key":"b4","series-title":"Science","first-page":"744","article-title":"Red squirrels in the British Isles are infected with leprosy bacilli","volume":"354","author":"Avanzi","year":"2016"},{"issue":"8","key":"b5","series-title":"Emerg Infect Dis","first-page":"1698","article-title":"Case report of leprosy in central Florida, USA, 2022","volume":"29","author":"Bhukhan","year":"2023"},{"issue":"11","key":"b6","series-title":"Emerg Infect Dis","first-page":"1928","article-title":"Autochthonous leprosy without armadillo exposure, eastern United States","volume":"23","author":"Rendini","year":"2017"},{"issue":"9","key":"b7","series-title":"JAMA","first-page":"798","article-title":"Mounting evidence suggests leprosy is endemic in Florida","volume":"330","author":"Harris","year":"2023"},{"issue":"6","key":"b8","series-title":"Am J Clin Pathol","first-page":"856","article-title":"A new Mycobacterium species causing diffuse lepromatous leprosy","volume":"130","author":"Han","year":"2008"},{"issue":"7","key":"b9","series-title":"Emerg Infect Dis","first-page":"1376","article-title":"Systematic review of hansen disease attributed to Mycobacterium lepromatosis.","volume":"29","author":"Collin","year":"2023"},{"issue":"3","key":"b10","series-title":"Am J Trop Med Hyg","first-page":"522","article-title":"Two cases of leprosy in siblings caused by Mycobacterium lepromatosis and review of the literature","volume":"95","author":"Sotiriou","year":"2016"},{"key":"b11","series-title":"Front Microbiol","first-page":"698588","article-title":"Mycobacterium lepromatosis as a second agent of Hansen\u2019s disease","volume":"12","author":"Deps","year":"2021"},{"key":"b12","series-title":"JAAD Case Rep","first-page":"21","article-title":"Lepromatous leprosy infection from Mycobacterium lepromatosis without known risk factors or exposures in the Upper Midwest United States","volume":"45","author":"Fleischmann","year":"2024"},{"key":"b13","series-title":"Canada J Drugs Dermatol","first-page":"229","article-title":"Leprosy-like illness in a patient with Mycobacterium lepromatosis from Ontario","volume":"11","author":"Jessamine","year":"2012"},{"issue":"6758","key":"b14","series-title":"Science","first-page":"eadu7144","article-title":"Pre-European contact leprosy in the Americas and its current persistence","volume":"389","author":"Lopopolo","year":"2025"},{"issue":"9","key":"b15","series-title":"Nat Ecol Evol","first-page":"1685","article-title":"4,000-year-old Mycobacterium lepromatosis genomes from Chile reveal long establishment of Hansen\u2019s disease in the Americas","volume":"9","author":"Ramirez","year":"2025"},{"issue":"14","key":"b16","series-title":"Proc Natl Acad Sci USA","first-page":"4459","article-title":"Insight into the evolution and origin of leprosy bacilli from the genome sequence of Mycobacterium lepromatosis.","volume":"112","author":"Singh","year":"2015"},{"issue":"13","key":"b17","series-title":"Vet Rec","first-page":"416","article-title":"Leprosy in red squirrels in the UK","volume":"184","author":"Schilling","year":"2019"},{"issue":"2","key":"b18","series-title":"Transbound Emerg Dis","first-page":"1032","article-title":"Lack of evidence for the presence of leprosy bacilli in red squirrels from North-West Europe","volume":"67","author":"Ti\u00f3-Coma","year":"2020"},{"key":"b19","series-title":"Microb Pathog","first-page":"119","article-title":"Looking in amoebae as a source of mycobacteria","volume":"77","author":"Drancourt","year":"2014"},{"issue":"4","key":"b20","series-title":"Lepr Rev","first-page":"401","article-title":"The role of free-living pathogenic amoeba in the transmission of leprosy: A proof of principle","volume":"79","author":"Lahiri","year":"2008"},{"issue":"3","key":"b21","series-title":"Dermatol Clin","first-page":"563","article-title":"Nontuberculous mycobacteria: Skin and soft tissue infections","volume":"33","author":"Gonzalez-Santiago","year":"2015"},{"issue":"10","key":"b22","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"1873","article-title":"Added diagnostic value of 16S rRNA gene pan-mycobacterial PCR for nontuberculous mycobacterial infections: A 10-year retrospective study","volume":"38","author":"Simon","year":"2019"},{"issue":"11","key":"b23","series-title":"Open Forum Infect Dis","first-page":"ofy257","article-title":"Microbial identification using DNA target amplification and sequencing: Clinical utility and impact on patient management","volume":"5","author":"Basein","year":"2018"},{"key":"b24","series-title":"J Cutan Pathol","first-page":"795","article-title":"Mycobacterial infection identified with broad-range PCR amplification and suspension array 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persistence","volume":"389","author":"Lopopolo","year":"2025"},{"issue":"9","key":"b15","series-title":"Nat Ecol Evol","first-page":"1685","article-title":"4,000-year-old Mycobacterium lepromatosis genomes from Chile reveal long establishment of Hansen\u2019s disease in the Americas","volume":"9","author":"Ramirez","year":"2025"},{"issue":"14","key":"b16","series-title":"Proc Natl Acad Sci USA","first-page":"4459","article-title":"Insight into the evolution and origin of leprosy bacilli from the genome sequence of Mycobacterium lepromatosis.","volume":"112","author":"Singh","year":"2015"},{"issue":"13","key":"b17","series-title":"Vet Rec","first-page":"416","article-title":"Leprosy in red squirrels in the UK","volume":"184","author":"Schilling","year":"2019"},{"issue":"2","key":"b18","series-title":"Transbound Emerg Dis","first-page":"1032","article-title":"Lack of evidence for the presence of leprosy bacilli in red squirrels from North-West 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