1/16. Identification of Leptospira andamana isolated from the spinal fluid of a fatal case of leptospirosis in Sao Paulo, 1963.The IAL-S. P. strain was isolated from the spinal fluid of a patient male, aged 35, black, a sewer worker with fever, myalgia, jaundice, vomiting and meningitis symptoms with a 5-day incubation period after the lower half of the body had been submerged for 2 hours in sewers when unblocking a drain. Leptospires were isolated by direct inoculation of the spinal fluid taken on the 9th day of the illness into the Fletcher's media and into guinea pigs by the intraperitoneal route. The patient gave a positive agglutination test for L. andamana with cross-reaction with L. sejroe. The strain was identified as L. andamana by the cross-agglutination-lysis test and the cross-absorption test. The IAL-S. P. strain is undoubtedly not saprophytic but parasitic and pathogenic for man and animals, however its biological properties resist to the oligodynamic action of Cu and Hg and the 8-azoguanine action as in the case of the Patoc 1 strain. I could be recommended to reconsider whether the strain belongs to L. interrogans, L. biflexa or to another group because the grounds for L. andamana being saprophytic were denied by this report.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
2/16. Massive rhabdomyolysis and multiple organ dysfunction syndrome caused by leptospirosis.We report a case of leptospiral infection in a 63-year-old man who acquired the infection while swimming in canals and streams in hawaii. The patient's course was atypical in that he was anicteric and had no evidence of meningitis when he presented with fever, rapidly progressive and severe rhabdomyolysis, thrombocytopenia, acute renal failure, and respiratory distress syndrome. Although he recovered after a protracted illness, he required major life support, including mechanical ventilation and hemodialysis. Initial antimicrobial therapy was designed to cover major bacterial and atypical pathogens, including leptospires. An in-depth work-up for causes of this catastrophic illness confirmed acute leptospirosis. Although rare, leptospirosis is a potentially lethal infection classically associated with hepatitis, azotemia, and meningitis. Most patients experience self-limited illness, with fever, myalgias, and malaise followed by an immune-mediated aseptic meningitis. A small proportion develop shock and multiple organ dysfunction. Whereas myalgias are ubiquitous in leptospiral infection, and most patients show mildly elevated muscle enzymes, life-threatening rhabdomyolysis is rare. This atypical case is reported to urge clinicians to consider leptospirosis in the evaluation of a patient with cryptogenic sepsis who develops multiple organ dysfunction associated with rhabdomyolysis. Appropriate antimicrobial therapy, with penicillin or doxycycline, can be life-saving.- - - - - - - - - - ranking = 1.1254637685343keywords = hepatitis (Clic here for more details about this article) |
3/16. leptospirosis complicated by severe aortic stenosis.A previously well 62-year-old male from North queensland presented with leptospirosis featuring fever, renal failure, hepatitis and pulmonary haemorrhage. Management was greatly complicated by severe and previously unrecognized aortic stenosis with a peak valve gradient of 125 mmHg. A successful outcome followed careful haemodynamic management and treatment of the infective illness with subsequent valve replacement.- - - - - - - - - - ranking = 1.1254637685343keywords = hepatitis (Clic here for more details about this article) |
4/16. leptospirosis mimicking acute cholecystitis among athletes participating in a triathlon.leptospirosis, a disease acquired by exposure to contaminated water, is characterized by fever accompanied by various symptoms, including abdominal pain. An acute febrile illness occurred in athletes who participated in an illinois triathlon in which the swimming event took place in a freshwater lake. Of 876 athletes, 120 sought medical care and 22 were hospitalized. Two of the athletes had their gallbladders removed because of abdominal pain and clinical suspicion of acute cholecystitis. We applied an immunohistochemical test for leptospirosis to these gallbladders and demonstrated bacterial antigens staining (granular and filamentous patterns) around blood vessels of the serosa and muscle layer. Rare intact bacteria were seen in 1 case. These results show that leptospirosis can mimic the clinical symptoms of acute cholecystitis. If a cholecystectomy is performed in febrile patients with suspicious environmental or animal exposure, pathologic studies for leptospirosis on formalin-fixed, paraffin-embedded tissues may be of great value.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
5/16. Acute renal failure caused by leptospirosis.Three patients with severe leptospirosis leading to anuria and treated with haemodialysis are reported. One patient died. The pathomechanism and the underlying pathological and histological changes of the renal failure are discussed. It is stressed that the clinical diagnosis of leptospirosis is often difficult, as other infectious diseases,first of all infectious hepatitis, frequently present the same symptoms.- - - - - - - - - - ranking = 1.1254637685343keywords = hepatitis (Clic here for more details about this article) |
6/16. Report of three children with leptospirosis in rural area of the east of turkey.leptospirosis is a systemic infection usually producing fever with hepatorenal involvement, meningoencephalitis, and hemorrhage. In this article, we present three children between 10 and 13 years of age with leptospirosis. The purpose of this paper is to emphasize that leptospirosis is a problem in our country with farmers/cattle and that leptospirosis should be considered in certain ill children. The main symptoms were headache, fever, fatigue, abdominal pain and unconsciousness. Two patients had hepatic and renal involvement. The other had hepatic, pulmonary and probably pericardial involvement. In all children spirochetes were demonstrated in blood and urine smears by dark-field microscopy and they were also isolated from urine and blood cultures by using Flecher medium. All patients were treated with penicillin; however, one subsequently required additional antibiotics due to klebsiella pneumoniae septicemia. While one patient was discharged in a good health, the others were taken to their home by parents without completing treatment. In conclusion, we would like to emphasize that leptospirosis is still a public health problem in our region (Eastern turkey) in where the majority of population are farmers and raise domestic animals such as cattle in rural areas. Additionally, leptospirosis should be considered in children admitted with headache, unconsciousness, fever and abdominal pain.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
7/16. Markedly prolonged jaundice from simultaneous infection with hepatitis e virus and leptospira.We treated a patient simultaneously infected with hepatitis e virus and leptospira interrogans, both acquired in china. Severe hyperbilirubinemia required nearly 200 days to resolve, transminase elevation showed a fluctuating course, and liver biopsy specimens showed fibrosis unusual for hepatitis E. leptospirosis appeared to have altered the course of hepatitis e virus infection in this patient, even though infection with Leptospira was cleared with antibiotics by 50 days after the onset of the hepatitis symptoms.- - - - - - - - - - ranking = 9.0037101482742keywords = hepatitis (Clic here for more details about this article) |
8/16. Reemerging leptospirosis, california.leptospirosis is a reemerging infectious disease in california. leptospirosis is the most widespread zoonosis throughout the world, though it is infrequently diagnosed in the continental united states. From 1982 to 2001, most reported california cases occurred in previously healthy young adult white men after recreational exposures to contaminated freshwater. We report five recent cases of human leptospirosis acquired in california, including the first documented common-source outbreak of human leptospirosis acquired in this state, and describe the subsequent environmental investigation. Salient features in the california cases include high fever with uniform renal impairment and mild hepatitis. Because leptospirosis can progress rapidly if untreated, this reemerging infection deserves consideration in febrile patients with a history of recreational freshwater exposure, even in states with a low reported incidence of infection.- - - - - - - - - - ranking = 1.1254637685343keywords = hepatitis (Clic here for more details about this article) |
9/16. leptospirosis in a caver returned from Sarawak, malaysia.This article describes a case of leptospirosis in a man who returned from caving in Sarawak, malaysia, and includes a discussion of epidemiology, pathophysiology, diagnosis, prevention, and treatment. The patient presented with symptoms of leptospirosis, which was confirmed by microhemagglutination titers. He became infected despite taking doxycycline daily for malaria prophylaxis. leptospirosis is an important consideration in any returned traveler with fever. The spirochete spreads from animals to humans via water. Caving in tropical endemic zones may increase exposure risk due to the combination of multiple skin abrasions with immersions. water in caves may increase infection risk because of increased water pH. Standard prophylaxis may be inadequate in cases of high-risk exposures.- - - - - - - - - - ranking = 1keywords = animal (Clic here for more details about this article) |
10/16. Nitric oxide production and immunoglobulin deposition in leptospiral hemorrhagic respiratory failure.Diffuse pulmonary hemorrhage leading to death is a syndrome which may develop in leptospirosis, but its pathophysiology is not well documented. We report an autopsy case of leptospirosis. A healthy 41-year-old man presented with low back myalgia, dry cough and fever for 4 days and a normal chest X-ray on admission. Acute respiratory failure developed hours later. Profuse bloody fluid appeared in the endotracheal tube immediately after intubation. Chest X-ray showed whiteness across all lung fields. He died of persistent shock 16 h after the onset of acute respiratory failure. autopsy revealed diffuse pulmonary hemorrhage with hyaline-membrane formation, myocarditis, interstitial nephritis and hepatitis. silver stain of lung and kidney tissue demonstrated leptospires. Immunohistochemical staining showed inducible nitric oxide synthase in alveolar macrophages. Immunofluorescein staining showed immunoglobulin in alveolar septum and alveolar space. This case suggests that hemorrhagic diffuse alveolar damage with persistent shock is related to over-production of nitric oxide and immunoglobulin deposition in fatal leptospirosis.- - - - - - - - - - ranking = 1.1254637685343keywords = hepatitis (Clic here for more details about this article) |
| | Next -> |