Isolated Bone Marrow Involvement of Lepromatous Leprosy in an HIV-infected Patient with No Apparent Skin Lesions: A Case Report

Leprosy caused by Mycobacterium leprae, primarily manifests with cutaneous and neurological symptoms.Bone marrow (BM) involvement without skin lesions is exceedingly rare, particularly in immunocompromised patients.Here is a case of a 40-year-old HIVinfected man with a nadir CD4 count of 29 cells/ mm who presented with recurrent anaemia, massive hepatosplenomegaly, and no apparent skin lesions.BM analysis revealed epithelioid granulomas with foamy histiocytes containing acid-fast bacilli, confirmed by Wade-Fite staining.This case highlights the rare presentation of lepromatous leprosy, emphasising the diagnostic challenges posed by the absence of typical cutaneous features.