Leptospirosis presenting with encephalitis-induced coma

Dimopoulou, Ioanna; Politis, Panagiotis; Panagyiotakopoulos, George; Moulopoulos, Lia A.; Θεοδωρακοπούλου, Μαρία; Bisirtzoglou, Danai; Routsi, Christina; Roussos, Charis

doi:10.1007/s00134-002-1476-2

Cited by 7 publications

(3 citation statements)

References 3 publications

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“…A four-fold increase in the titer of IgG antibodies confirmed the diagnosis one week later. After an extended stay in the ICU, the patient eventually passed away from a bloodstream infection [ 26 ]. In our case, our patient had negative IgM and IgG antibodies on the first evaluation upon admission, but after eight days the IgM antibodies were positive, confirming the diagnosis eventually.…”

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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“…Leptospira enters the bloodstream and disseminates throughout body tissue, contributing to leptospirosis and showing various clinical symptoms. The invasion of Leptospira into various organ tissues causes various clinical manifestations such as neuroleptospirosis [21][22][23][24][25][26][27][28][29], pulmonary leptospirosis [30][31][32][33][34], hepatic leptospirosis, hematological manifestations [35][36][37][38], leptospiral nephropathy [15,39], gastrointestinal manifestations [40][41][42], cardiac involvement [43], rhabdomyolysis [44], ocular and cutaneous leptospirosis [45,46]. Humans are incidental hosts because they do not excrete sufficient numbers of leptospires to serve as reservoirs for transmission.…”

Section: Discussionmentioning

confidence: 99%

Weil’s Disease in an HIV-Infected Patient: A Case Report and Literature Review

Zheng,

He,

Zhong

et al. 2023

Diagnostics

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Weil’s disease, an icterohemorrhagic infection, is the most severe and fatal form of leptospirosis and is characterized by jaundice, renal dysfunction, and hemorrhagic predisposition. Weil’s disease with HIV infection has rarely been reported. A 68-year-old male with HIV infection presented to our hospital with fever and dyspnea that progressed to severe hemoptysis and systemic multiple organ failure, necessitating a tracheal intubation ventilator. A diagnosis of Weil’s disease was made after Leptospira interrogans was identified via metagenomic next-generation sequencing (mNGS) in bronchoalveolar lavage fluid (BALF). After immediately receiving supportive therapy and targeted antimicrobial agents, the patient achieved complete recovery upon discharge. The co-infection of HIV infection and leptospirosis resulting in systemic multi-organ failure is rare, but awareness should be raised of the differential diagnosis. mNGS can help identify pathogens and facilitate the use of targeted and efficacious antimicrobial therapy in unusual clinical environments.

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“…The human leucocyte-like antigen DQ-6 (HLA-DQ6) polymorphism in has showed an increased risk of leptospirosis via consumption of contaminated water (Lingappa et al, 2004). Encephalitis onset has been reported (Dimopoulou et al, 2002).…”

Section: Leptospirosis: Leptospiramentioning

confidence: 99%