Cases reported "Leptospirosis"

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1/13. 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.
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2/13. Pulmonary haemorrhage as a predominant cause of death in leptospirosis in seychelles.

    We examined the cause of death during a 12-month period (1995/96) in all consecutive patients admitted to hospital with leptospiral infection in seychelles (indian ocean), where the disease is endemic. leptospirosis was diagnosed by use of the microscopic agglutination test and a specific polymerase chain reaction assay on serum samples. Seventy-five cases were diagnosed and 6 patients died, a case fatality of 8%. All 6 patients died within 9 days of onset of symptoms and within 2 days of admission for 5 of them (5 days for the 6th). On autopsy, diffuse bilateral pulmonary haemorrhage (PH) was found in all fatalities. Renal, cardiac, digestive and cerebral haemorrhages were also found in 5, 3, 3 and 1 case(s), respectively. Incidentally, haemoptysis and lung infiltrate on chest radiographs, which suggest PH, were found in 8 of the 69 non-fatal cases. dengue and hantavirus infections were ruled out. In conclusion, PH appeared to be a main cause of death in leptospirosis in this population, although haemorrhage in other organs may also have contributed to fatal outcomes. This cause of death contrasts with the findings generally reported in endemic settings.
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3/13. The first case of leptospirosis in the Zadar area.

    In September 1999, a 56-year-old butcher was admitted to the General Hospital in Zadar because of fever, headache, severe pain in the calf muscles and thighs, conjunctivitis, rash, hepatomegaly and jaundice. The initial diagnosis was septic shock, and the patient was admitted to the internal medicine ward. Microscopic agglutination test showed a fourfold rise of antibodies to Leptospira sejroe in the three serum samples. These serologic findings and laboratory findings of leukocytosis, thrombocytopenia, increased serum aminotransferases, blood urea nitrogen and creatinine, proteinuria and leukocyturia indicated that Leptospira sejroe was the etiologic agent of the disease in the patient presented.
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4/13. leptospirosis: report of one case.

    An 8-year-old male aborigine was referred to our hospital with a presumptive diagnosis of Kawasaki disease. The major symptom presented was a persistent fever for six days. Several other symptoms were drowsiness, headache, nausea, vomiting, abdominal pain, diarrhea, nuchal rigidity, lymphadenopathy, subconjunctival hemorrhage, and muscle aching of the calf. During hospitalization, cerebrospinal fluid studies showed pleocytosis. Abdominal sonograms revealed hepatosplenomegaly, moderate ascites and gallbladder wall thickening. These data were suggestive of leptospirosis. The microscopic agglutination test of leptospiral antibodies further confirmed the diagnosis. After treatment with intravenous aqueous penicillin and gentamicin, the clinical course improved significantly.
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5/13. First evidence of leptospirosis in vanuatu.

    The clinical picture of leptospirosis is often confusing and biological confirmation with reference tests (microagglutination test or isolation of the organism) is not usually possible in tropical countries where the disease remains undiagnosed. We report here the first human cases of leptospirosis in vanuatu (South Pacific), which occurred during the 1989-1990 epidemic of dengue, and discuss the differential diagnosis of the 2 diseases.
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6/13. leptospirosis presenting with fever and pulmonary hemorrhage.

    Reports of leptospirosis have recently been increasing in taiwan. We report a case of leptospirosis with the unusual initial manifestation of pulmonary hemorrhage. The patient presented with cough for 1 week and was admitted. After admission, fever, hemoptysis and severe dyspnea developed suddenly. Chest radiograph showed bilateral diffuse pulmonary infiltrates and he was transferred to the emergency room of our hospital. oxygen saturation was 86% under room air and respiratory rate was 30 per minute. After admission to the thoracic ward on the third morning, parenteral penicillin and trimethoprim-sulfamethoxazole were given empirically, and a dramatic recovery ensued. Microscopic agglutination test showed an increased titer of 1:6400 against Leptospira interrogans serogroup shermani on the fourth day of hospitalization. Neither jaundice nor renal insufficiency occurred during treatment. Pulmonary hemorrhage may be an under-recognized manifestation of leptospirosis in Taiwanese patients. leptospirosis should be taken into consideration in the differential diagnosis of pulmonary hemorrhage. Early treatment can lead to cure with reduced morbidity.
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7/13. Leptospiral pneumonia.

    Severe leptospirosis rarely presents with primary pulmonary manifestations, without any associated jaundice or renal dysfunction. The authors report a nine-year-old boy who presented with complaints of abrupt onset of high fever; with myalgia, headache, and pain in right chest region, productive cough with hemoptysis and vomiting developing over the past 72 hours. Chest radiograph showed consolidation in the right upper lobe with air bronchogram. A history of contact with sewage water and presence of conjunctival suffusion in a child with pneumonia made us suspect leptospirosis. Following prompt initiation of parenteral penicillin therapy the child's complaints resolved over the next five days. Dri-Dot test to detect anti-Leptospira antibodies was positive. The diagnosis of leptospirosis was confirmed by a positive microagglutination test to leptospira interrogans serovar australis by a fourfold rise in antibody titer in paired sera collected during convalescence. leptospirosis presenting with pulmonary hemorrhage has been associated with significant mortality but it can be successfully treated with early clinical suspicion of alveolar hemorrhage and prompt therapy.
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8/13. 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.
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9/13. leptospirosis presenting with mania and psychosis: four consecutive cases seen in a military hospital in turkey.

    OBJECTIVE: To present the clinical features and the treatment alternatives of manic and psychotic symptoms in patients with leptospirosis. methods: Clinical observation and diagnosis of four cases with leptospirosis presenting with psychiatric symptoms. RESULTS: leptospirosis diagnoses were established by recovery of the organism from culture, macroagglutination tests, and dark field microscopy in all cases. Leptospira ELISA-Ig M was also positive in all cases. Microagglutination tests were positive in case 1 and case 2. All of the cases were also screened for other possible medical, infectious, and neurological disorders that could account for their clinical symptoms. patients were treated with a combination of antibiotics, antipsychotics and mood stabilizers. CONCLUSIONS: The presence of manic and psychotic symptoms with fever and high transaminase and/or CPK levels in high risk occupational groups during rainy periods should alert the physician to the possibility of leptospirosis. The psychiatric symptoms are sensitive to anti-psychotics and mood stabilizers but not to antimicrobial treatment, suggesting that the psychiatric picture may not be related to direct invasion of the central nervous system by the infectious agent.
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10/13. Peripheral nerve palsy in a case of leptospirosis.

    We describe an unusual case of leptospirosis in a 54-year-old man presenting peripheral nerve palsy. The diagnosis of leptospirosis was confirmed by ELISA IgM and the microscopic agglutination test. Electrophysiological studies showed that no response could be obtained from the right fibular nerve. At 7 months after the initiation of treatment, additional electrophysiological studies and a neurological examination showed, respectively, a chronic axonal lesion of right fibular nerve with signs of re-innervation and a nearly complete clinical recovery. We feel that this case may serve to remind clinicians that peripheral nerve palsy is a potential clinical feature of leptospirosis.
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