Management of an infected wound complicated by osteomyelitis secondary to neuropathy caused by previous leprosy; successful treatment with gauze ribbon, Multivitamins, and maggot therapy

Abstract

Introduction: Neuropathy, particularly commonly seen in the form of benign osteomyelitis, is a leading cause of wound formation and severe bone deformity. Leprosy, a chronic disease caused by Mycobacterium leprae and Mycobacterium lepromatosis, initially presents with asymptomatic infections that can remain so for 5 to 20 years. Hansen’s disease, caused by Mycobacterium leprae, presents a disease spectrum influenced by the patient’s immune response, ranging from tuberculoid to lepromatous.Case presentation:In this case study, maggot therapy was utilized as a novel method to address the wound. This study aimed to heal a wound and prevent amputation in a 76-year-old leprosy patient with osteomyelitis of the metatarsophalangeal joint. Diagnosed with leprosy at 45, he presented numbness in his legs up to the waist and hand, indicating neuropathy. The condition, linked to inadequate joint care, led to osteomyelitis. The patient sought treatment due to a wound in the metatarsophalangeal area.Laboratory tests, wound cultures, and imaging studies revealed positive results for osteomyelitis, prompting consideration of leg amputation. However, preservation of the leg without amputation through joint and bone osteotomy was successfully achieved, demonstrating an alternative to amputation in select cases. Conclusion: This study underscores the importance of tailored and multidisciplinary approaches in addressing challenging wound healing issues in patients with leprosy. It emphasizes the significance of individualized care and the potential benefits of integrating diverse therapeutic interventions to achieve successful outcomes.

Keywords

• Osteomyelitis
• Leprosy
• Wound
• Mycobacterium leprae
• Case report