# Postpartum sepsis-like illness and rash associated with Hansen’s disease

## TL;DR

A postpartum woman developed a sepsis-like illness and rash, later diagnosed as Hansen’s disease, highlighting the importance of skin biopsies for rare diagnoses.

## Contribution

This case emphasizes the diagnostic value of skin biopsies in postpartum patients with severe, atypical rashes.

## Key findings

- A postpartum patient presented with a sepsis-like illness and worsening rash, later confirmed as Hansen’s disease via skin biopsy.
- HD can mimic other conditions, leading to delayed diagnosis if not evaluated with biopsy.
- Early treatment of HD is crucial to prevent nerve damage and disability.

## Abstract

Hansen’s disease (HD) often manifests during pregnancy and the postpartum. Patients with HD may experience reactions that mimic other conditions making diagnosis challenging.

We present a case of a patient from Chuuk, a state of the Federated States of Micronesia with a sepsis-like illness and worsening painful rash immediately postpartum. Antepartum, the patient noted a pruritic rash on her legs. Four hours after delivery, the patient became febrile and later developed systemic inflammatory response syndrome (SIRS). The rash rapidly spread to other areas of her body and became painful and edematous. Eight weeks after delivery, a skin biopsy revealed tuberculoid granulomatous dermatitis consistent with HD.

HD and its associated reactions are easily misdiagnosed. Performing a skin biopsy of unusual skin lesions or common skin lesions with severe illness in a pregnant patient can expedite diagnosis of rare conditions such as HD. Early initiation of treatment for HD and its reactions are critical to prevent serious nerve damage and permanent disability.