<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0123-9392</journal-id>
<journal-title><![CDATA[Infectio]]></journal-title>
<abbrev-journal-title><![CDATA[Infect.]]></abbrev-journal-title>
<issn>0123-9392</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Infectología.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0123-93922017000100056</article-id>
<article-id pub-id-type="doi">10.22354/in.v21i1.642</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Lepra neural pura de 18 años de evolución]]></article-title>
<article-title xml:lang="en"><![CDATA[18 years of pure neuritic leprosy]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Jaramillo]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Giraldo]]></surname>
<given-names><![CDATA[Natalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arboleda]]></surname>
<given-names><![CDATA[Margarita]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[Gerzaín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad del CES Dermatología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Clínica Cardio VID  ]]></institution>
<addr-line><![CDATA[Medellín ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Colombiano de Medicina Tropical|Universidad CES  ]]></institution>
<addr-line><![CDATA[Apartadó ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Universidad de La Sabana Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Chía ]]></addr-line>
<country>Cundinamarca</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Centro Dermatológico Federico Lleras Acosta  ]]></institution>
<addr-line><![CDATA[Bogotá ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>01</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>01</month>
<year>2017</year>
</pub-date>
<volume>21</volume>
<numero>1</numero>
<fpage>56</fpage>
<lpage>60</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0123-93922017000100056&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0123-93922017000100056&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0123-93922017000100056&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen La lepra puede presentar dificultades diagnósticas, especialmente en la forma neural primaria. Un hombre de 38 años, exsoldado y trabajador rural, presentó durante más de 10 años hiperestesia supraclavicular y supraescapular izquierdas y anestesia progresiva escapular y en guante de la mano y brazo izquierdos, con reabsorción ósea de las falanges distales del primero y segundo dedos de la misma mano, cambios que le dificultaban realizar sus labores; no tenía lesiones cutáneas de lepra. El nervio cubital izquierdo presentaba engrosamiento epitroclear, por lo que se sospechó lepra neural pura. Las baciloscopias de moco, pabellones auriculares y codos fueron negativas, al igual que los anticuerpos IgM contra el glicolípido fenólico 1; dos biopsias de piel de zonas anestésicas fueron normales también. La electromiografía evidenció disminución notoria de los potenciales sensitivos de los nervios cubital, radial y mediano izquierdos, lo cual favoreció el diagnóstico de lepra neural primaria. Se inició tratamiento para lepra multibacilar por tener afección de más de un tronco nervioso, dos meses después comenzó a presentar mejoría notoria de los síntomas y logró reanudar sus actividades comunes y laborales. La lepra neural primaria cursa con zonas de hipoestesia y anestesia cutánea y engrosamiento neural troncular, puede permanecer sin diagnóstico durante años. La electromiografía, que demuestra disminución de los potenciales sensitivos, es una ayuda diagnóstica considerable, mientras la biopsia de piel anestésica ayuda al diagnóstico solo en la tercera parte de los casos. La sospecha clínica razonable es suficiente para iniciar tratamiento antileproso, cuando no se dispone de otros medios diagnósticos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Leprosy can be difficult to diagnose, in particular the pure neuritic leprosy type. A 38-year-old male, former soldier and rural worker, presented with a 10-year history of supraclavicular and suprascapular hyperesthesia of the left side and progressive scapular left arm anesthesia, including the hand, associated with bone resorption in distal phalanges of the first and second finger. No typical leprosy skin changes were present. An examination of the skin revealed epitrochlear thickening of the left side cubital nerve, therefore primary neural leprosy was suspected. Skin smears from the routine sites were normal, as were two skin biopsies and the serologic assay specific for M leprae to detect phenolic glycolipid-1. Electromyography revealed an important reduction in the sensory action potential of the ulnar, radial and medial nerves, which favored the primary neural leprosy diagnosis. After two months of multibacillar leprosy treatment, the symptoms started to disappear and the patient could recommence his old job. Pure neuritic leprosy presents with skin areas of hypesthesia and anesthaesia associated with nerve thickening. It is a disease that is commonly misdiagnosed for several years before the correct diagnosis is made and effective treatment is started. Electromyography can be a helpful tool in the diagnosis, typically showing reduced sensory action potential, while a biopsy of anesthetic skin is only helpful in one-third of cases. Reasonable clinical suspicion is sufficient to initiate antileprosy treatment when no other diagnostic methods are available.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Mycobacterium leprae]]></kwd>
<kwd lng="es"><![CDATA[Lepra]]></kwd>
<kwd lng="es"><![CDATA[Electromiografía]]></kwd>
<kwd lng="es"><![CDATA[Anestesia]]></kwd>
<kwd lng="es"><![CDATA[Hipoestesia]]></kwd>
<kwd lng="es"><![CDATA[Anomalías cutáneas]]></kwd>
<kwd lng="en"><![CDATA[Mycobacterium leprae]]></kwd>
<kwd lng="en"><![CDATA[Leprosy]]></kwd>
<kwd lng="en"><![CDATA[Electromyography]]></kwd>
<kwd lng="en"><![CDATA[Anesthesia]]></kwd>
<kwd lng="en"><![CDATA[Hypesthesia]]></kwd>
<kwd lng="en"><![CDATA[Skin abnormalities]]></kwd>
</kwd-group>
</article-meta>
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