Sputum AFB smear positivity in leprosy – confounding the diagnosis

Tuberculosis and leprosy remain among the devastating infectious diseases of the world. Both share common epidemiological characteristics such as overcrowding and poverty. TB-leprosy co-infection is a well-known association, however sometimes establishing the accurate diagnosis can be difficult. Although the detection of acidfast bacilli (AFB) is considered as an initial clue in the diagnosis of pulmonary TB, non-tuberculous mycobacteria (NTM) also can exhibit positivity towards sputum AFB.

We present 2 cases of sputum AFB positivity in lepromatous leprosy which baffled the diagnosis.