Características de la lepra infantil en el Hospital Mennonita km. 81 / Characteristcs of leprosy in children at the Mennonite Hospital at kilometer 81

RESUMEN

Introducción: La Lepra infantil sigue siendo una patología poco descripta y sub valorada en la consulta diaria. El diagnóstico exige buena habilidad clínica porque las lesiones cutáneas son asintomáticas y pueden pasar desapercibidas. Objetivo: Presentar una casuística pediátrica y dar ponderancia a los criterios clínicos y epidemiológicos para el diagnóstico. Material y Método: Estudio descriptivo, retrospectivo. En 73 casos se observó contacto familiar intradomiciliario. La clínica y la epidemiología fueron los pilares básicos del diagnóstico, pues la baciloscopía resultó negativa en el 78% de los casos. Conclusión: La lepra figura dentro de las enfermedades reemergentes en nuestro país y a nivel mundial, razón por la cual el pediatra debe pensar en ella para el diagnóstico diferencial ante un paciente con lesiones cutáneas y/o alteraciones sensitivas, y orientar el interrogatorio en la búsqueda de antecedentes familiares de la afección.

ABSTRACT

Introduction: Leprosy in children remains a pathology that is little described, and is underestimated in routine examination. Diagnosis of leprosy requires superior clinical skills because the lesions of the skin are asymptomatic and can pass unnoticed. Objective: To present pediatric case material and offer considerations concerning clinical and epidemiological criteria for diagnosis. Materials and Methods: A retrospective descriptive study. We evaluated 88 patient records stored in the archives of the Mennonite Hospital loca-ted at Kilometer 81, Route 2, Paraguay, from the time period of January 2000 until June of 2003, analyzing age, gender, clinical signs leading to diagnosis, time of progression, bacilloscopy the form of leprosy (lepromatous or tuberculoid), and history of contacts. Results: The most affected age group (42%) was that of ages 10- to 14-years of age, among males (58%), the most common form is tuberculoid, or paucibacillary leprosy (27 cases) and lepromatous, or multibacillary leprosy (25 cases). In 73 cases, intra-household contact was observed. Clinical examination and epidemiology were the primary tools for diagnosis, given that bacilloscopy was negative in 78% of patients. Conclusion: Leprosy is a disease that is re-emerging in Paraguay and around the world, for that reason pediatricians should consider it in differential diagnosis when faced with a patient with lesions of the skin or changes in sensitivity, and should ask questions to elicit any family history of the disease.