Coinfection of Pulmonary Tuberculosis and Leprosy with Type 1 Leprosy Reaction: A Case Report

Tuberculosis and leprosy are two of the oldest diseases that has become a global health burden. They are known to have similar geographic endemicity, thriving mostly in tropical climate countries. They are caused by gram positive aerobic acid-fast bacilli, but the occurrence of coinfection between these two diseases are rarely presented. We report a case of leprosy complicated with type 1 leprosy reaction diagnosed in a 28 year old male being treated for pulmonary tuberculosis. Patient came with skin lesions and soreness on both elbows that started 2 weeks after consuming anti-TB regiments. Diagnosis was made by clinically and histopathology. Patient then was given combination therapy of anti-TB regiments and MDT leprosy regiments. Low dose steroids was given for short term duration to manage the type 1 leprosy reaction. Knowledge of these mycobacterial infections are important, particularly for clinician practicing in developing countries. Unrecognised coinfection may predispose the risk of Rifampicin resistant during treatment. Screening for tuberculosis in the presence of leprosy is important before starting the therapy regiment, and likewise. Steroids therapy for leprosy reaction in the case of coinfection may be given with lower adjusting dose to prevent the reactivation of TB.