A case of primary neuroleptospirosis

Chang, Aapt; Ranawaka, U.K.; Gunasekara, H; Wijesekera, J.

doi:10.4038/cmj.v48i4.3335

Cited by 9 publications

(5 citation statements)

References 8 publications

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“…Considering previous detection of high levels of Leptospira DNA in the kidneys and liver of infected hamsters (Coutinho et al., 2014; Wunder et al., 2016), possible brain damage induced by the disease (Panicker et al., 2001; Chang et al., 2003), and culture constraints, we selected these three organs for detection of live leptospires through culture (Table 1). Live leptospires were obtained from almost all kidney and brain homogenate cultures and in one-third of liver homogenate cultures from L. interrogans- infected hamsters.…”

Section: Resultsmentioning

confidence: 99%

“…Retracted glomeruli, dilated tubules, and an abundance of hyaline casts in the kidneys have commonly been observed in L. interrogans infection (Arean, 1962; Zhang et al., 2012; Forster et al., 2013). Although the induction of nervous system damage by L. interrogans has been previously reported in human cases (Forwell et al., 1984; Brown et al., 2003; Chang et al., 2003; El Bouazzaoui et al., 2011), experimental infection studies mainly report damage and high leptospiral load in the kidneys, lungs, and liver only (Silva et al., 2008; Lourdault et al., 2009; Fujita et al., 2015). Four weeks following infection, L. mayottensis was present only in the kidneys as indicated by high leptospiral DNA amounts and the presence of live leptospires.…”

Section: Discussionmentioning

confidence: 99%

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Three Leptospira Strains From Western Indian Ocean Wildlife Show Highly Distinct Virulence Phenotypes Through Hamster Experimental Infection

Cordonin

Turpin

Bascands³

et al. 2019

Front. Microbiol.

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Leptospirosis is one of the most widespread zoonoses worldwide, with highest incidence reported on tropical islands. Recent investigations carried out in a One-Health framework have revealed a wide diversity of pathogenic Leptospira lineages on the different islands of Western Indian Ocean carried out by a large diversity of mammal reservoirs, including domestic and wild fauna. Using golden Syrian hamsters as a model of acute infection, we studied the virulence of Leptospira interrogans, L. mayottensis, and L. borgpetersenii isolates obtained from rats, tenrecs, and bats, respectively. Hamsters were inoculated with 2.108 bacterial cells and monitored for 1 month. The L. interrogans isolate proved to be the most pathogenic while L. mayottensis and L. borgpetersenii isolates induced no clinical symptoms in the infected hamsters. High leptospiral DNA amounts were also detected in the urine and organs of hamsters infected with the L. interrogans isolate while L. mayottensis and L. borgpetersenii isolates mostly failed to disseminate into the organism. In addition, histological damage was more pronounced in the kidneys and lungs of hamsters infected with the L. interrogans isolate. Altogether, these data support that Leptospira strains shed by mammals endemic to this insular ecosystem (L. mayottensis and L. borgpetersenii isolates) are less pathogenic than the L. interrogans rat-borne isolate. These results may provide a relevant framework for understanding the contrasting epidemiology of human leptospirosis observed among Western Indian Ocean islands.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Three Leptospira Strains From Western Indian Ocean Wildlife Show Highly Distinct Virulence Phenotypes Through Hamster Experimental Infection

Cordonin

Turpin

Bascands³

et al. 2019

Front. Microbiol.

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“…All the patients suffered from headache, some of them also had symptoms such as vomiting, fever, and chills [ 14 , 17 , 18 , 19 , 20 ]. One patient had sudden onset of paraparesis, two had seizures, and one patient appeared with decreased responsiveness to commands, decreased verbal output, and inability to move his limbs [ 14 , 20 , 21 , 22 ]. Bandara et al present two cases of neuroleptospirosis with headache, vomiting, and photophobia [ 23 ], and Zhang et al reported a case of Leptospirosis-associated meningitis in a patient with sjögren’s syndrome [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

A Fatal Case of Presumptive Diagnosis of Leptospirosis Involving the Central Nervous System

Alexopoulou,

Proklou,

Kokkini

et al. 2024

Healthcare

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Leptospirosis is a reemerging zooanthroponosis with a worldwide distribution, though it has a higher incidence in areas with tropical climate. A characteristic finding of the disease is its wide spectrum of symptoms and organ involvement, as it can appear either with very mild flu-like manifestations or with multiorgan failure, affecting the central nervous system (CNS) with a concomitant hepatorenal dysfunction (Weil’s syndrome) and significant high mortality rate. We report herein a fatal case of a 25 years old female, previously healthy, with impaired neurological status. She had high fever and severe multiorgan failure. The clinical data and the epidemiological factors were not conclusive for the diagnosis, and the first serology test from the cerebrospinal fluid (CSF) and sera samples were negative. When the repetition of the blood test showed elevated IgM antibodies, Leptospirosis was the presumptive diagnosis. Although CNS involvement is rare, the diagnosis should be considered when there is an elevated risk of exposure. The diagnostic protocol should encompass direct evidence of the bacterium and indirect measurement of antibodies. Timely detection and management are imperative to forestall complications and fatality associated with the disease.

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“…Worsening of sensorium in form of decreased responsiveness to commands, decreased verbal output and inability to move his limbs. None 5 Chang et al, 2003 [ 11 ] A case of primary neuroleptospirosis Sudden onset of paraparesis, urinary retention, and numbness below his upper abdomen of 3 weeks duration. None 6 Mathew et al, 2006 [ 7 ] Neuroleptospirosis - Revisited: Experience from a tertiary care neurological centre from South India Acute fever with chills and rigors, headache and vomiting, altered sensorium, acute symptomatic seizures None 7 Saeed et al, 2018 [ 3 ] First reported case of neuroleptospirosis complicated with Anton’s syndrome Flu-like illness with fever, myalgia and headache, seizures, reduced consciousness None 8 Waggoner et al, 2015 [ 12 ] Case report: Molecular detection of leptospira in two returned travelers: Higher bacterial load in cerebrospinal fluid versus serum or plasma Fever with chills, headaches, myalgia, nausea, vomiting, and loose stools.…”

Section: Discussionmentioning

confidence: 99%

Aseptic meningitis as the initial presentation of Leptospira borgpetersenii serovar Tarassovi: two case reports and a literature review

et al. 2021

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Background Leptospirosis is a zoonotic illness caused by pathogenic spirochetes of the genus Leptospira. The disease spectrum ranges from a mild influenza-like presentation to a more serious Weil’s syndrome. Leptospirosis rarely presents as a primary neurological syndrome. We report two cases of Leptospira borgpetersenii serovar Tarasssovi presenting as aseptic meningitis in Sri Lanka. Case presentation We describe case reports of two patients presenting as symptomatic aseptic meningitis due to neuroleptospirosis. Both patients had significant neurological involvement at presentation in the absence of common clinical features of leptospirosis. These patients were initially managed as bacterial or viral meningitis and leptospirosis was suspected due to a history of exposure to contaminated water. Subsequently, they were diagnosed to have neuroleptospirosis by positive Leptospira serology and both patients gained full recovery. Conclusion Our report highlights the importance of considering leptospirosis as a differential diagnosis in patients with aseptic meningitis in endemic settings. Obtaining a detailed occupational and recreational history is helpful in diagnosing neuroleptospirosis promptly. We report the association of Leptospira borgpetersenii serovar (sv.) Tarassovi (strain bakeri) in causing aseptic meningitis, which has not been reported to the best of our knowledge.

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A case of primary neuroleptospirosis

Cited by 9 publications

References 8 publications

Three Leptospira Strains From Western Indian Ocean Wildlife Show Highly Distinct Virulence Phenotypes Through Hamster Experimental Infection

Three Leptospira Strains From Western Indian Ocean Wildlife Show Highly Distinct Virulence Phenotypes Through Hamster Experimental Infection

A Fatal Case of Presumptive Diagnosis of Leptospirosis Involving the Central Nervous System

Aseptic meningitis as the initial presentation of Leptospira borgpetersenii serovar Tarassovi: two case reports and a literature review

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