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A case of lepromatous leprosy with bone marrow involvement in a 37 year old man is presented. Bone marrow aspiration was performed for evaluation of anemia and leukopenia. Ziehl-Neelsen stain demonstrated numerous bacilli lying free in the interstitium and in the cytoplasm of foamy macrophages. The patients was treated with dapsone, rifampicin and thalidomide, and obtained a good response. Bone marrow evaluation is useful in the initial study and surveillance of selected patients with lepromatous leprosy and hematological abnormalities.
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