Indeterminate leprosy and lepromatous index case: four cases in the same family * Hanseníase indeterminada e caso índice virchowiano: 4 casos na mesma família

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, which primarily affects the skin and peripheral nerves. Brazil remains as the country with the second largest number of cases in the world. We report the case of three patients diagnosed with indeterminate leprosy in the same family. Two patients were HIV positive. An active search led to the discovery of the index case. It was crucial to persist in the search of the index case. This report shows how important it is to teach physicians and the general population about the signs and symptoms of leprosy. Early diagnosis and treatment are necessary to prevent sequelae and to eliminate the disease as a public health problem. Keywords: HIV; Leprosy; Leprosy, lepromatous; Leprosy, paucibacillary Resumo: A hanseniase e uma doenca infecciosa cronica causada pelo Mycobacterium leprae, que afeta principal- mente a pele e nervos perifericos. O Brasil continua sendo o segundo pais do mundo com maior numero de casos. Aqui relatamos tres pacientes diagnosticados com hanseniase indeterminada, pertencentes a mesma familia, cuja busca ativa levou a descoberta do caso indice. Dois pacientes eram HIV positivos. Foi de imensa importância a insistencia na procura pelo caso indice. Este relato ilustra a importância do ensino sobre sinais e sintomas de han- seniase na formacao medica e a populacao. O pronto reconhecimento e tratamento sao necessarios para prevenir sequelas e eliminar a doenca como problema de saude publica. Palavras-chave: Hanseniase; Hanseniase Paucibacilar; Hanseniase Virchowiana; HIV