# Hansen’s disease patient in Ohio successfully treated with a monthly rifampin, minocycline, and moxifloxacin regimen: a case report

## TL;DR

A patient in Ohio with Hansen’s disease was successfully treated with a new monthly regimen of three antibiotics, showing this treatment is effective even without recent international travel.

## Contribution

This case report demonstrates the successful use of a new monthly multidrug regimen (RMM) for treating Hansen’s disease in a non-international traveler.

## Key findings

- A 78-year-old male with Hansen’s disease was successfully treated with monthly rifampin, moxifloxacin, and minocycline.
- The patient showed clinical improvement without recent international travel, highlighting the domestic occurrence of the disease.
- The RMM regimen is a viable alternative for patients who may have intolerance to first-line drugs.

## Abstract

Hansen’s disease, also known as leprosy, is an infection of the skin and peripheral nerves that is rarely encountered in the United States. This case describes a patient without recent international travel who achieved a successful therapeutic outcome using a new monthly multidrug treatment regimen recommended by the National Hansen’s Disease Program.

A 78-year-old male presented with peripheral neuropathy, widespread macular erythematous rash involving face, trunk, extremities, bilateral hand edema, and oligoarticular unilateral elbow and knee bursitis. A skin biopsy revealed a lymphohistiocytic infiltrate in the presence of acid-fast bacilli (AFB) without globi. No AFB were recovered from tissue culture. Direct molecular testing from the skin biopsy detected Mycobacterium leprae. The patient had no recent risk factors for contracting Hansen’s disease, other than travel to Florida. The patient was treated with a monthly multidrug therapy regimen of rifampin, moxifloxacin, and minocycline (RMM) and had successful clinical reduction in disease manifestations.

Hansen’s disease is uncommon in the United States, especially in the Midwest. However, providers should include Hansen’s disease on their differential even if recent travel was only domestic, particularly to Florida. In addition, the monthly multidrug treatment regimen RMM is an effective monthly treatment alternative, especially for patients with concerns of intolerance to first-line drugs.