Cases reported "Leptospirosis"

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1/8. 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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2/8. 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.
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3/8. 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.
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4/8. 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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5/8. Brief report: leptospirosis after flooding of a university campus--hawaii, 2004.

    On November 19, 2004, the hawaii Department of Health (HDOH) received a report that a University of hawaii professor aged 56 years had been hospitalized with suspected leptospirosis after cleaning his flooded laboratory. On October 31, heavy rains had caused an adjacent stream to overflow its banks and flood the campus. persons exposed to fresh water or mud contaminated by the urine of animals infected with the spirochete leptospira interrogans can have systemic illness if the leptospires enter the body through broken skin or mucous membranes. This report describes the subsequent investigation by HDOH, assisted by CDC, which highlights the importance of maintaining clinical suspicion for leptospirosis after flooding in areas where the illness is endemic, even in well-developed urban settings.
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6/8. Hemolytic anemia associated with leptospirosis. Morphologic and lipid studies.

    A case of fulminant hemolytic anemia associated with a leptospiral infection is presented with morphologic and erythrocyte lipid studies. Both the frequency and pathogenesis of anemia in human leptospirosis is poorly understood. The anemia frequently observed in Weil's syndrome has been ascribed on clinical impression to blood loss, renal failure, and/or an ill-defined hemolytic process. However, hemolytic anemia associated with leptospirosis in animals is well documented and is due to hemolysins with phospholipase activity. Our patient's erythrocyte morphologic abnormalities on bright light and electron microscopy included particles of cells and cells with a thorny or spiculated surface suggesting that the hemolytic process was due to membrane injury. Measurement of the erythrocyte membrane lipids showed reductions in sphingomyelin and phosphatidylethanolamine suggesting that the observed hemolysis and morphologic changes resulted from phospholipases produced by the infecting leptospirae.
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7/8. leptospirosis in nepal.

    We present here a case report of a suspected leptospiral infection in a Nepali soldier, and the results of a serological survey of 188 residents of Eastern nepal that indicate the infection may be common there. This is the first report of leptospirosis in nepal although it is known to affect man and animals in most of the temperate and tropical regions of the world, and apparently occurs widely in india (Das Gupta, 1938; Khanna & Iyer, 1971).
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8/8. Dynamic changes in the epidemiology of canicola fever in israel. Natural adaptation of an established serotype to a new reservoir host.

    Investigation of human leptospirosis caused by the serotype canicola revealed a significant shift in the chain of infection of this disease. The adaptation of an old and well-established serotype to a new and abundant host, the norway rat, provides a new means for spreading and transferring canicola fever to man and farm animals. The changes in the epidemiology of leptospirosis described should serve as a warning to epidemiologists responsible for suggesting proper prophylactic measures.
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