Leprosy suspect presenting at a chest clinic.

Leprosy is an ancient ailment, also known as Hansen's disease. It primarily involves the superficial peripheral nerves, skin, upper respiratory tract mucosa, eyes, bones and testicles, but not the lungs. Although leprosy patients are not included in the study area of pulmonology, here we present an undiagnosed leprosy patient with a history of smoking, who was referred owing to upper respiratory tract symptoms and bilateral pleural effusions. From this undiagnosed case, we would like to draw specific attention of pulmonologists, since a patient with leprosy can present in this way due to hypoalbuminemia resulting from a systemic inflammatory state, which may then progress to sepsis. Collaboration of different specialists may be required to clinch extra-neurological and extra-cutaneous features of leprosy.