You go to Hall Health and a blood smear gives the diagnosis. Immune evasion mechanism parallels Afrrican trypanosomiasis. Most individuals exposed to Mycobacterium leprae do not become ill. His respiratory infections improve with treatment but soon recurs. He has attended day care since 9 mo of age.
Immunizations are up to date without problems.
There is one healthy sibling and both parents have hay fever. The lassitude progresses and his respiratory rate increases. When he arrives at the emergency room, he is hypotensive, listless and has a diffuse petetchial and purpuric rash. A maternal uncle died of a similar process in childhood, which was thought to be meningococcal sepsis. He later developed leg cellulitis due to S marcescens and Aspergillus pneumonitis.