Leprosy in the Upper Midwest.

Introduction: Leprosy is a life-threatening infection caused by Mycobacterium leprae with an average 5-year long incubation period. It is curable when treated early. Early diagnosis requires knowledge of its myriad clinical features as risk factors may not be readily apparent.

Case presentation: We report the case of a male patient from Wisconsin who tested positive for leprosy without a known exposure or recent travel to endemic areas.

Discussion: The clinical presentation of leprosy exists on a spectrum and correlates with cell immunity levels. The Ridley-Jopling and World Health Organization classifications are used to define leprosy subtypes and guide treatment. Histopathologic examination may aid in diagnosis of suspicious presentations.

Conclusions: Leprosy may present with nonspecific clinical features and elevated inflammatory markers leading to a misdiagnosis. It should be considered on the differential diagnosis for suspicious presentations and appropriately worked up with various diagnostic modalities. A multidisciplinary approach to treatment may prevent spread and permanent damage.