Leptospirosis-associated meningitis in a patient with sjögren’s syndrome: a case report

Zhang, Yifan; Zheng, Yong

doi:10.1186/s12879-023-08794-9

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…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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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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Atypical Cases of Leptospirosis: Insights From Georgia

Dehkordi,

Al-Tamary,

Al-Tamary

et al. 2024

Case Reports in Infectious Diseases

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Pathogenic Leptospira species are the source of leptospirosis, a common zoonotic infection that can cause a wide range of clinical manifestations, from minor flu‐like symptoms to severe multiorgan failure. We present two peculiar cases of leptospirosis; they highlight the need for clinical awareness to improve patient outcomes and further knowledge of leptospirosis epidemiology and therapy by illuminating the difficulties in diagnosis and treatment. The first case involved a 30‐year‐old male presented with jaundice. Although he had no history of chronic illnesses, an exhaustive investigation was warranted due to his recent travel history and occupational contact. Laboratory tests revealed significantly increased levels of AST and ALT and positive Leptospira IgM serology. Remarkably, the patient refuted the traditional theory of leptospirosis transmission by denying direct animal interaction. After starting therapy with dexamethasone initially and adding doxycycline later, the patient’s condition significantly improved; his jaundice resolved and his liver enzyme levels returned to normal. An outpatient follow‐up after discharge was advised to assess liver and kidney function. The second case involved an 87‐year‐old woman with a fever, weakness and hypertension. Investigations revealed hepatosplenomegaly, raising the possibility of hypersplenism. She reported exposure to animals, particularly her dogs in her urban house. Surprisingly, her AST and ALT levels were normal. Lab tests also revealed thrombocytopoenia with normal APTT and prolonged PT. Serological tests indicated positive Leptospira IgM. Along with intravenous infusions, the patient’s treatment plan comprised dexamethasone, enalapril and ceftriaxone to treat inflammation, hypertension and bacterial infection, respectively. Following a 20‐day hospital stay, the patient’s laboratory results and symptoms improved, leading to her discharge. Continuous follow‐up recommended to monitor her recovery and prevent recurrence. These case studies emphasise the significance of taking leptospirosis into account when treating patients who do not have normal exposure histories yet present with unusual symptoms.

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Leptospirosis in China: Current Status, Insights, and Future Prospects

Jiang,

Zhang,

et al. 2024

Zoonoses

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Leptospirosis is a re-emerging zoonotic disease that significantly impacts animals and human health worldwide. China has diverse climate types, providing a suitable environment for transmitting and surviving pathogenic Leptospira and its host animals. Despite the substantial reduction in the prevalence of leptospirosis, it continues to be a significant zoonotic disease of public health concern in China. This literature review aimed to provide a concise overview of the current status of leptospirosis in China, the findings from epidemiologic studies on leptospirosis, and the impact of animal and environmental factors on leptospirosis. Leptospirosis is commonly observed in subtropical and tropical cities in China, especially cities with ample water resources in the southern Yangtze River basin. Epidemiologic studies have identified Leptospira interrogans and L. borgpetersenii as the predominant pathogenic species responsible for leptospirosis in China. Leptospira serotypes prevalent in one part of China are related to the serotypes prevalent in the dominant local rodent species and these animals may threaten public health safety as carriers. Given the potential increase in the risk of leptospirosis due to extreme climate change, it is crucial to raise awareness among stakeholders and promote the adoption of a comprehensive approach to prevent and control the continuous transmission and sudden outbreaks of leptospirosis.

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Leptospirosis-associated meningitis in a patient with sjögren’s syndrome: a case report

Cited by 3 publications

References 23 publications

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

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

Atypical Cases of Leptospirosis: Insights From Georgia

Leptospirosis in China: Current Status, Insights, and Future Prospects

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