Table 1 Timeline of the patient from the initial presentation
8 February 2017 | The patient visited our hospital. Admitted to evaluate the cause of fever |
14 February 2017 | ENT consultation for cervical lymphadenopathy FNAC of cervical lymph node: reactive lymphadenitis |
22 February 2017 | The patient developed a skin lesion over his lower leg. Dermatological consultation was done. A skin biopsy was performed. The biopsy was inadequate and repeat was advised. |
26 February 2017 | A provisional diagnosis of pyrexia of unknown origin was made. Bone marrow aspiration with a biopsy was performed. Bone marrow showed myeloid hyperplasia suggesting inflammatory pathology. |
2 March 2017 | A diagnosis of adult-onset Still’s disease was made. Prednisolone 40 mg was started. |
6 March 2017 | Fever subsided and the patient was discharged |
29 March 2017 | Fever reappeared with cervical lymphadenopathy |
29 March 2017 | FNAC inguinal lymph node: granulomatous lymphadenitis |
3 April 2017 | ATT started |
8 April 2017 | Nodular skin rash on shoulder, back, and face developed |
10 April 2017 | Skin biopsy: erythema nodosum leprosum |
18 April 2017 | Referred to Anandaban Leprosy Hospital |
18 April 2017 | Slit-skin smear: 4+ |
18 April 2017 | Diagnosed as lepromatous leprosy with erythema nodosum leprosum |
18 April 2017 | MBMDT with prednisolone |