Leptospirosis during the COVID-19 pandemic: a case report

Abstract

Since SARS-CoV-2 disease (COVID-19) has been labeled as a pandemic, it took the spotlight in the differential diagnosis for patients presenting with acute respiratory and systemic symptoms. Leptospirosis is one of the most common zoonoses in the world, yet it is mainly a disease of differential diagnosis for places that do not have it as an endemic. Due to the high burden of COVID-19 on the healthcare field, patients suffering from other infections may have been inadvertently neglected. COVID-19 infection can mimic other infectious diseases and can confuse physicians in their search for a confirmatory diagnosis. Nonetheless, it is very crucial to broaden the differential diagnosis and keep diseases like leptospirosis within the differential diagnosis despite its rarity, especially in patients presenting with unexplained systemic infectious symptoms. This is a unique case of a patient who presented with dyspnea, jaundice and change in urine color who was suspected to be COVID-19 positive. After a detailed investigation, the patient was diagnosed with leptospirosis instead of COVID-19 and was treated with plasmapheresis and antibiotics accordingly.

First report of human infection with Leptospira interrogans serovar Bratislava in the Eastern Black Sea region of Turkey

“…The clinical course of some patients might progress to severe hyperbilirubinemia, acute renal failure, hemorrhagic features, sepsis, multiple organ failure, coma, and death 11 . Due to this wide range of clinical spectrum, it might be challenging to make differential diagnosis from nonspecific diseases such as COVID-19 12 . Moreover, neither a routine laboratory test was reported as diagnostic nor was any association revealed between a lab test and mortality for this disease.…”

“…Supportive treatment with doxycycline, ampicillin, or ceftriaxone is usually sufficient and successful for treating mild/moderate forms of the disease. However, advanced therapies such as plasmapheresis, cyclophosphamide, and ventilatory support might be necessary for patients with severe leptospirosis 12 , 13 . Thus, all the suspected cases must be evaluated for the possible diagnosis of leptospirosis and, when diagnosed, carefully followed up for the severe disease.…”