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Gutiérrez JD, Tapias-Rivera J. Pooled lagged effect of runoff on leptospirosis cases in Colombia. Heliyon 2024; 10:e32882. [PMID: 38988573 PMCID: PMC11234012 DOI: 10.1016/j.heliyon.2024.e32882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/12/2024] Open
Abstract
Leptospirosis is a global zoonotic disease caused by spirochete bacteria of the genus Leptospira. The disease exhibits a notable incidence in tropical and developing countries, and in Colombia, environmental, economic, social, and cultural conditions favor disease transmission, directly impacting both mortality and morbidity rates. Our objective was to establish the pooled lagged effect of runoff on leptospirosis cases in Colombia. For our study, we included the top 20 Colombian municipalities with the highest number of leptospirosis cases. Monthly cases of leptospirosis, confirmed by laboratory tests and spanning from 2007 to 2022, were obtained from the National Public Health Surveillance System. Additionally, we collected monthly runoff and atmospheric and oceanic data from remote sensors. Multidimensional poverty index values for each municipality were sourced from the Terridata repository. We employed causal inference and distributed lag nonlinear models to estimate the lagged effect of runoff on leptospirosis cases. Municipality-specific estimates were combined through meta-analysis to derive a single estimate for all municipalities under study. The pooled results for the 20 municipalities suggest a lagged effect for the 0 to 2, and 0-3 months of runoff on leptospirosis when the runoff is < 120 g/m2. No effect was identified for longer lagged periods (0-1, 0 to 4, 0 to 5, and 0-6 months) or higher runoff values. Incorporation of the multidimensional poverty index into the meta-analysis of runoff contributed to the models for the lagged periods of 0-3, and 0-4 months.
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Affiliation(s)
- Juan David Gutiérrez
- Universidad de Santander, Facultad de Ciencias Médicas y de La Salud, Instituto Masira, Bucaramanga, Santander, Colombia
| | - Johanna Tapias-Rivera
- Universidad de Santander, Facultad de Ciencias Exactas, Naturales y Agropecuarias, Grupo de Investigación en Ciencias Agropecuarias-GICA, Bucaramanga, Santander, Colombia
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Miida S, Maruyama M, Sato T, Nagoya T, Goto R, Isokawa O, Koizumi N, Terai S. Acute pancreatitis as a rare complication of leptospirosis: A case report and literature review. J Infect Chemother 2024; 30:552-556. [PMID: 38052307 DOI: 10.1016/j.jiac.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023]
Abstract
Leptospirosis is a zoonotic disease. We present a case of acute pancreatitis associated with leptospirosis. An 88-year-old woman was admitted to the hospital with high fever and severe myalgia of the lower extremities. Based on the clinical presentation, hepatic dysfunction with a mild increase in bilirubin, renal dysfunction, and life history, the possibility of leptospirosis was considered. Plain computed tomography of the trunk on admission revealed no special findings. Appropriate antimicrobial therapy was administered at an early stage. After treatment initiation, the clinical symptoms and blood test abnormalities began to improve, and the patient appeared to be doing well. Although no abdominal or back pain was consistently noted during hospitalization, the serum amylase level increased over time; therefore, the patient underwent another computed tomography scan on the ninth day. Acute pancreatitis, which was absent upon admission, was noted. Appropriate treatment for pancreatitis was administered, and the patient was discharged. A subsequent serum antibody test confirmed the diagnosis of leptospirosis. Herein, we also summarized previous cases of acute pancreatitis associated with leptospirosis. The time of onset for pancreatitis was inconsistent, and there were a few cases of pancreatitis without abdominal or back pain. In contrast, serum amylase or lipase levels were elevated in all patients, which could be an important trigger for suspected complications of pancreatitis. When leptospirosis is suspected, complications of pancreatitis should always be considered, even in the absence of apparent abdominal pain. Regular monitoring of pancreatic enzymes such as amylase and lipase is recommended.
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Affiliation(s)
- Suguru Miida
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
| | - Masaki Maruyama
- Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Kashiwazaki, Japan
| | - Takeki Sato
- Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Kashiwazaki, Japan
| | - Takuro Nagoya
- Department of Gastroenterology and Hepatology, Tsubame Rosai Hospital, Tsubame, Niigata, Japan
| | - Ryo Goto
- Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Kashiwazaki, Japan
| | - Osamu Isokawa
- Department of Gastroenterology, Kashiwazaki General Hospital and Medical Center, Kashiwazaki, Japan
| | - Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Kumar D, Prasad ML, Kumar M, Munda SS, Vidyapati. An Insight Into Various Manifestations of Leptospirosis: A Unique Case Series From a State in Eastern India. Cureus 2024; 16:e56802. [PMID: 38659535 PMCID: PMC11042753 DOI: 10.7759/cureus.56802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Leptospirosis presents with highly variable clinical manifestations affecting different organ systems in different individuals. The presentation ranges from an asymptomatic or mild disease to a severe disease associated with multiorgan failure and higher mortality. Leptospirosis is highly underreported due to a lack of diagnostic modalities and less suspicion among clinicians. METHODOLOGY We present this single-center retrospective case series of 12 cases, which include various common and uncommon scenarios by which the disease can present and can be missed due to lack of suspicion. The study contains individual patient characteristics including demographic, laboratory, clinical, and treatment data. The association between these variables and mortality was analyzed using p-values and results were described. A p-value of<0.05 was considered statistically significant. RESULTS A total of 12 cases were included in the study. The male-to-female ratio was 3:1. The mean age was higher (37.75±9.81 years) in cases who died than those who recovered (34.25±14.09). Factors like history of alcoholism, presence of chronic liver disease (CLD), jaundice, acute renal failure, requirement of dialysis, and requirement of intensive care were significantly associated with increased risk of death (odds ratio >1, p-value <0.05). The most common symptom of presentation was fever in 11 (91.66%) cases. Jaundice and renal failure were significantly associated with death (odds ratio 1.2, p-value 0.04). The requirement of intensive care treatment (odds ratio 2.1, p-value 0.05) and dialysis (odds ratio 39.66, p-value 0.03) were also significantly associated with death. The percentage of death was lower in the group of patients who received combination antibiotic therapy. CONCLUSION Leptospirosis has varied presentations in different individuals and the diagnosis can be missed due to lack of specific signs and symptoms. Severe diseases involving multiple organs and preexisting comorbidities are associated with higher mortality rates. Timely diagnosis and treatment are necessary to reduce mortality and increase survival.
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Affiliation(s)
- Divakar Kumar
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | | | - Mukesh Kumar
- Community Medicine, Phulo Jhano Medical College, Dumka, IND
| | - Shiv S Munda
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
| | - Vidyapati
- Internal Medicine, Rajendra Institute of Medical Sciences, Ranchi, IND
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Bedoya-Pérez MA, Westman ME, Loomes M, Chung NYN, Knobel B, Ward MP. Pathogenic Leptospira Species Are Present in Urban Rats in Sydney, Australia. Microorganisms 2023; 11:1731. [PMID: 37512903 PMCID: PMC10383884 DOI: 10.3390/microorganisms11071731] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
Leptospirosis is an emerging disease among people and dogs in Sydney, Australia. However, the routes of Leptospira transmission in these cases, and in particular the possible role of rats as reservoirs of infection in Sydney, are unknown. Rats were collected within the City of Sydney Council area and their kidneys were tested for pathogenic Leptospira DNA by real-time (q)PCR. A subset of rats also had qPCR testing performed on whole blood and urine, and Microscopic Agglutination Testing (MAT) that included a panel of 10 Leptospira serovars from nine different Leptospira serogroups was performed on a subset of serum samples. Based on qPCR testing, the proportion of rats with Leptospira DNA in their kidneys was 9/111 (8.1%). qPCR testing of blood samples (n = 9) and urine (n = 4) was negative. None of the 10 serum samples tested MAT positive. A primary cluster of qPCR-positive locations was detected based on six infected rats, which partially overlapped with a previously identified cluster of canine leptospirosis cases in Sydney. These findings suggest that rats in Sydney might play a role in the transmission of leptospirosis to dogs and people. Further testing of rats in Sydney and investigation into other possible wildlife reservoirs of infection and environmental sources of leptospires are needed.
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Affiliation(s)
- Miguel A Bedoya-Pérez
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW 2006, Australia
| | - Mark E Westman
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia
- Elizabeth Macarthur Agricultural Institute (EMAI), Woodbridge Road, Menangle, NSW 2568, Australia
| | - Max Loomes
- Brain and Mind Centre, The University of Sydney, Sydney, NSW 2050, Australia
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW 2006, Australia
| | - Nga Yee Natalie Chung
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia
| | - Benjamin Knobel
- Elizabeth Macarthur Agricultural Institute (EMAI), Woodbridge Road, Menangle, NSW 2568, Australia
| | - Michael P Ward
- Sydney School of Veterinary Science, The University of Sydney, Sydney, NSW 2006, Australia
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Shi J, Wu W, Wu K, Ni C, He G, Zheng S, Cheng F, Yi Y, Ren R, Jiang X. The diagnosis of leptospirosis complicated by pulmonary tuberculosis complemented by metagenomic next-generation sequencing: A case report. Front Cell Infect Microbiol 2022; 12:922996. [PMID: 36268227 PMCID: PMC9577070 DOI: 10.3389/fcimb.2022.922996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/15/2022] [Indexed: 11/20/2022] Open
Abstract
Leptospirosis is a zoonotic infection caused by the pathogenic Leptospira. Leptospirosis is transmitted mainly through contact with contaminated rivers, lakes, or animals carrying Leptospira. Human leptospirosis has a wide range of non-specific clinical manifestations ranging from fever, hypotension, and myalgia to multi-organ dysfunction, which severely hampers the timely clinical diagnosis and treatment of leptospirosis. Therefore, there is an urgent clinical need for an efficient strategy/method that can be used for the accurate diagnosis of leptospirosis, especially in critically ill patients. Here, we report a case of a 75-year-old male patient with clinical presentation of fever, cough, and diarrhea. Initial laboratory tests and a computed tomography (CT) scan of the chest suggested only tuberculosis. The patient was finally diagnosed with pulmonary tuberculosis (PTB) combined with leptospirosis by sputum Xpert MTB RIF, epidemiological investigations, and delayed serological testing. Furthermore, through metagenomic next-generation sequencing (mNGS) of clinical samples of cerebrospinal fluid (CSF), urine, plasma and sputum, the causative pathogens were identified as Mycobacterium tuberculosis complex and Leptospira spp. With specific treatment for both leptospirosis and tuberculosis, and associated supportive care (e.g., hemodialysis), the patient showed a good prognosis. This case report suggests that mNGS can generate a useful complement to conventional pathogenic diagnostic methods through more detailed etiological screening (i.e., at the level of species or species complex).
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Affiliation(s)
- Jichan Shi
- Department of Infectious Disease, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, China
| | - Wenjie Wu
- Institute of Innovative Applications, MatriDx Biotechnology Co., Ltd, Hangzhou, China
| | - Kang Wu
- Institute of Innovative Applications, MatriDx Biotechnology Co., Ltd, Hangzhou, China
| | - Chaorong Ni
- Institute of Infectious Diseases, Center for Disease Control and Prevention, Wenzhou, China
| | - Guiqing He
- Department of Infectious Disease, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, China
| | - Shilin Zheng
- Department of Infectious Disease, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, China
| | - Fang Cheng
- Department of Infectious Disease, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, China
| | - Yaxing Yi
- Institute of Innovative Applications, MatriDx Biotechnology Co., Ltd, Hangzhou, China
| | - Ruotong Ren
- Institute of Innovative Applications, MatriDx Biotechnology Co., Ltd, Hangzhou, China
- Foshan Branch, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- *Correspondence: Ruotong Ren, ; Xiangao Jiang,
| | - Xiangao Jiang
- Department of Infectious Disease, Wenzhou Central Hospital, The Dingli Clinical College of Wenzhou Medical University, Wenzhou, China
- *Correspondence: Ruotong Ren, ; Xiangao Jiang,
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6
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Acute kidney injury in leptospirosis: A country-level report. Travel Med Infect Dis 2022; 49:102359. [PMID: 35660008 DOI: 10.1016/j.tmaid.2022.102359] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 02/08/2023]
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Chieng Raymond SC. Leptospirosis. WIKIJOURNAL OF MEDICINE 2022. [DOI: 10.15347/wjm/2022.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Leptospirosis is a blood infection caused by the bacterium Leptospira. Signs and symptoms can range from none to mild (headaches, muscle pains, and fevers) to severe (bleeding in the lungs or meningitis). Weil's disease, the acute, severe form of leptospirosis, causes the infected individual to become jaundiced (skin and eyes become yellow), develop kidney failure, and bleed. Pulmonary hemorrhage in association with leptospirosis is known as "severe pulmonary haemorrhage syndrome". More than ten genetic types of Leptospira, which are a type of a spirochaete, cause disease in humans. Both wild and domestic animals can spread the disease, most commonly rodents. The bacteria are spread to humans through animal urine, or water and soil contaminated with animal urine, coming into contact with the eyes, mouth, nose or breaks in the skin. In developing countries, the disease occurs most commonly in farmers and low-income people who live in areas with poor sanitation. In developed countries, it occurs during heavy downpours and can affect those involved in outdoor activities in warm and wet areas. Diagnosis is typically by testing for antibodies against the bacteria or finding bacterial DNA in the blood. Efforts to prevent the disease include protective equipment to block contact when working with potentially infected animals, washing after contact, and reducing rodents in areas where people live and work. The antibiotic doxycycline is effective in preventing leptospirosis infection. Human vaccines are of limited usefulness; vaccines for other animals are more widely available. Treatment when infected is with antibiotics such as doxycycline, penicillin, or ceftriaxone. The overall risk of death is 5–10%. However, when the lungs are involved, the risk of death increases to the range of 50–70%. It is estimated that one million people worldwide are infected by leptospirosis every year, causing approximately 58,900 deaths. The disease is most common in tropical areas of the world but may occur anywhere. Outbreaks may arise after heavy rainfall. The disease was first described by physician Adolf Weil in 1886 in Germany. Infected animals may have no, mild or severe symptoms. These may vary by the type of animal. In some animals Leptospira live in the reproductive tract, leading to transmission during mating.
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Weiner M, Coen M, Serratrice J, Mavrakanas TA, Leidi A. Acute kidney injury with partial Fanconi syndrome in a patient with leptospirosis: a case report. J Med Case Rep 2021; 15:358. [PMID: 34294111 PMCID: PMC8299617 DOI: 10.1186/s13256-021-02978-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/18/2021] [Indexed: 12/30/2022] Open
Abstract
Background Leptospirosis is an underdiagnosed bacterial infection with nonspecific symptoms, hence, a diagnostic challenge. Identifying a case of leptospirosis in Switzerland is uncommon. Although kidney complications are frequent in severe forms, including tubular dysfunction, observing this complication is rare in our country. We report the case of a patient with leptospirosis and kidney dysfunction, which was notable for proximal tubulopathy. This case report describes the diagnosis and management of this patient’s tubular dysfunction. Case presentation A 34-year-old Caucasian male known for alcohol and drug abuse presented to our emergency department suffering from severe pain in the lower limbs, jaundice, and fever with flu-like symptoms. Physical examination was not contributory. Blood tests showed cytopenia, elevated inflammatory markers, acute kidney injury, and altered liver function tests with predominant cholestasis. Urinalysis showed proteinuria and significant glycosuria without concomitant hyperglycemia. Leptospirosis was suspected and confirmed by both positive serum polymerase chain reaction and elevated immunoglobulin M for Leptospira interrogans. The patient was treated with intravenous amoxicillin–clavulanate and doxycycline for 7 days. After antibiotic treatment, symptoms disappeared, and kidney dysfunction completely resolved. Conclusion Our case focuses on the description of leptospirosis-related acute kidney injury with proximal tubular dysfunction, which is a rare finding in Switzerland.
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Affiliation(s)
- Marc Weiner
- Department of General Internal Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
| | - Matteo Coen
- Department of General Internal Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.,Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, 1211, Geneva, Switzerland
| | - Jacques Serratrice
- Department of General Internal Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
| | - Thomas A Mavrakanas
- Division of Nephrology, Department of Medicine, McGill University Health Centre, 1001 Decarie Boulevard, Montreal, QC, Canada
| | - Antonio Leidi
- Department of General Internal Medicine, Geneva University Hospital, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
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Chacko CS, Lakshmi S S, Jayakumar A, Binu SL, Pant RD, Giri A, Chand S, UP N. A short review on leptospirosis: Clinical manifestations, diagnosis and treatment. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Rahman SA, Khor KH, Khairani-Bejo S, Lau SF, Mazlan M, Roslan A, Goh SH. Detection and characterization of Leptospira spp. in dogs diagnosed with kidney and/or liver disease in Selangor, Malaysia. J Vet Diagn Invest 2021; 33:834-843. [PMID: 34148436 DOI: 10.1177/10406387211024575] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Leptospirosis is a serious bacterial disease that affects both humans and animals. A wide range of symptoms have been described in humans; the disease in dogs is commonly associated with kidney and/or liver disease. In Malaysia, information about the common serovars infecting dogs is limited. Therefore, we investigated the occurrences of leptospirosis in 124 pet dogs diagnosed with kidney and/or liver disease. Blood, urine, abdominal effusion, and/or kidney and liver were collected from the dogs. Based on microscopic agglutination testing, 53 of 124 (42.7%) dogs were seropositive for leptospiral exposure. Sera were frequently positive to serovars Bataviae (n = 12), Javanica (n = 10), and Icterohaemorrhagiae (n = 10). Direct detection using PCR showed that 42 of 124 (33.9%) of the whole blood and 36 of 113 (31.9%) urine samples were positive for pathogenic Leptospira spp. By PCR, 2 of 23 (9.1%) kidney and 2 of 23 (9.1%) liver were positive for pathogenic Leptospira spp. Abdominal effusion from 4 dogs were PCR-positive for pathogenic Leptospira spp. The species detected were L. interrogans, L. borgpetersenii, L. kirschneri, and L. kmetyi by partial 16S rRNA sequencing. We further identified and characterized 11 Leptospira spp. isolates from 8 dogs as serovars Bataviae, Javanica, and Australis. The mortality rate of the Leptospira-infected dogs was high (18 of 53; 34%).
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Affiliation(s)
- Sabri A Rahman
- Departments of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Kuan H Khor
- Departments of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Siti Khairani-Bejo
- Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Seng F Lau
- Departments of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Mazlina Mazlan
- Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Azri Roslan
- Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Soon H Goh
- Departments of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.,Faculty of Veterinary Medicine, Universiti Malaysia Kelantan, Kota Bharu, Kelantan, Malaysia
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Cook H, Gompels M. The wrong Spirochaete? Acute kidney injury in a returning traveller with syphilis - a case report. BMC Infect Dis 2020; 20:692. [PMID: 32957955 PMCID: PMC7507709 DOI: 10.1186/s12879-020-05418-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/14/2020] [Indexed: 11/29/2022] Open
Abstract
Background Syphilis has seen an increased incidence in recent years and can have serious and irreversible consequences if left un-diagnosed and untreated. This case report describes a presentation of syphilis and acute kidney injury – a scenario sparsely described in existing literature. Case presentation This 43-year old Man who has Sex with Men (MSM) presented to the emergency department with a 3-week history of vomiting and headaches, progressing to include pyrexia. These symptoms started following his return from a 2-week cruise in Central America throughout which he had been well. He had a background of well-controlled human immunodeficiency virus (HIV). On admission he had an Acute Kidney Injury (AKI) stage 3, without hydronephrosis, presumed to be pre-renal. Leptospirosis, the main differential, was negative serologically. ‘Pyrexia of unknown origin’ testing was performed, and cefuroxime commenced. Later in the admission, syphilis testing indicated an acute infection and he completed a full treatment course of benzylpenicillin. This, alongside intravenous fluids, resulted in symptom and renal resolution in 9 days and restoration of renal function. Conclusions Renal complications in syphilis are rare, furthermore the majority of those documented occur in latent syphilis and are irreversible. There are limited numbers of other documented cases of AKI in acute syphilis, which like the gentleman in this case were reversible and did not lead to permanent kidney damage. This case adds to the knowledge base of AKI in initial presentation of syphilis. It also demonstrates not only the importance of taking a sexual history in patients with new infective symptoms but that testing for syphilis in at-risk groups regardless of history should be performed given its rising incidence. These considerations by physicians can lead to prompt diagnosis and management of syphilis and improve patient care and long-term outcomes.
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Affiliation(s)
- Hannah Cook
- Immunology, North Bristol NHS Trust, Southmead Road, Bristol, BS10 5NB, UK.
| | - Mark Gompels
- Immunology, North Bristol NHS Trust, Southmead Road, Bristol, BS10 5NB, UK
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12
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Gomes PEADC, Brilhante SDO, Carvalho RB, Sousa DRD, Daher EDF. Pancreatitis as a severe complication of leptospirosis with fatal outcome: a case report. Rev Inst Med Trop Sao Paulo 2020; 61:e63. [PMID: 31859840 PMCID: PMC6907415 DOI: 10.1590/s1678-9946201961063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 11/01/2019] [Indexed: 01/21/2023] Open
Abstract
Leptospirosis is a globally distributed zoonosis with a broad clinical spectrum.
This disease mostly affects liver and kidney tissues. Other organs such as the
pancreas, can be affected by leptospirosis-induced vasculitis. In addition,
cardiac manifestations are common, and the presence of transient ECG
abnormalities can be found in 70% of the patients. We report a male patient who
presented with an atypical leptospirosis that progressed with severe acute
pancreatitis, acute kidney injury and atrial fibrillation. Early diagnosis and
adequate supportive therapy are crucial for the appropriated management of
symptoms.
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Affiliation(s)
- Pedro Eduardo Andrade de Carvalho Gomes
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Medicina Clínica, Programa de Pós-Graduação em Ciências Médicas, Fortaleza, Ceará, Brazil
| | - Sávio de Oliveira Brilhante
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Medicina Clínica, Programa de Pós-Graduação em Ciências Médicas, Fortaleza, Ceará, Brazil
| | - Rachel Bezerra Carvalho
- Hospital Geral de Fortaleza, Programa de Residência Médica em Nefrologia, Fortaleza, Ceará, Brazil
| | | | - Elizabeth De Francesco Daher
- Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Medicina Clínica, Programa de Pós-Graduação em Ciências Médicas, Fortaleza, Ceará, Brazil
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Vock I, Scholz MC, Stettler CD, Shabb DW, Martinez AE. [CME: Zoonosis in Switzerland: Leptospirosis]. PRAXIS 2019; 108:519-524. [PMID: 31185842 DOI: 10.1024/1661-8157/a003255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
CME: Zoonosis in Switzerland: Leptospirosis Abstract. Leptospirosis is worldwide a common zoonosis that also occurs in Switzerland. Frequently it presents as a self-limited, mild illness. The more severe presentation with jaundice and sever acute kidney injury (Weil's disease) is, however, associated with a high morbidity and mortality. In order to make the diagnosis, it is important to recognize the typical findings and perform the appropriate diagnostic workup. In this article, we discuss the clinical signs, diagnostic workup, therapy and prevention of leptospirosis and present the case of a 54-year-old patient with severe leptospirosis.
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Affiliation(s)
- Isabelle Vock
- 1 Medizinische Klinik, Spital Rheinfelden, Gesundheitszentrum Fricktal
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Relation of reproductive disturbance in sheep and Leptospira interrogans serovar Icterohaemorrhagiae infection: Impacts on cellular oxidation status. Microb Pathog 2019; 130:65-70. [DOI: 10.1016/j.micpath.2019.02.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 11/22/2022]
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