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Suzuki T, Morioka S, Kikuchi T, Sato L, Nomoto H, Yamamoto K, Koizumi N, Hayakawa K, Kutsuna S, Ohmagari N. Case Report: Leptospirosis by Wild Rat Bite in Winter in Tokyo Metropolitan Area, Japan. Am J Trop Med Hyg 2022; 107:tpmd211322. [PMID: 35576943 PMCID: PMC9294689 DOI: 10.4269/ajtmh.21-1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/21/2022] [Indexed: 11/07/2022] Open
Abstract
We report a case of leptospirosis in Tokyo in winter due to a rat bite, an uncommon cause of Leptospira infection. In Japan, many cases due to exposure to fresh water have been reported from domestic southwest islands in summer. However, a previous report on leptospirosis in Tokyo documented several cases occurring in winter. The main route of infection in the Tokyo metropolitan area during winter was attributed to the increased chance of direct rat exposure. Rapid and feasible diagnostic methods are needed to elucidate its epidemiology and provide prompt treatment.
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Affiliation(s)
- Tetsuya Suzuki
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Shinichiro Morioka
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tatsuya Kikuchi
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Lubna Sato
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidetoshi Nomoto
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Kei Yamamoto
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Nobuo Koizumi
- Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kayoko Hayakawa
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Satoshi Kutsuna
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Infection Control, Graduate School of Medicine/Faculty of Medicine, Osaka University, Osaka, Japan
| | - Norio Ohmagari
- Department of Infectious Diseases, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
- Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Sendai, Japan
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Faggion Vinholo T, Ribeiro GS, Silva NF, Cruz J, Reis MG, Ko AI, Costa F. Severe leptospirosis after rat bite: A case report. PLoS Negl Trop Dis 2020; 14:e0008257. [PMID: 32645040 PMCID: PMC7347098 DOI: 10.1371/journal.pntd.0008257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Thais Faggion Vinholo
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States
| | - Guilherme S. Ribeiro
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Nanci F. Silva
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Jaqueline Cruz
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Mitermayer G. Reis
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Brazil
| | - Albert I. Ko
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Federico Costa
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brazil
- Institute of Integrative Biology, University of Liverpool, Liverpool, United Kingdom
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Zilber AL, Belli P, Grezel D, Artois M, Kodjo A, Djelouadji Z. Comparison of Mucosal, Subcutaneous and Intraperitoneal Routes of Rat Leptospira Infection. PLoS Negl Trop Dis 2016; 10:e0004569. [PMID: 27031867 PMCID: PMC4816568 DOI: 10.1371/journal.pntd.0004569] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 03/02/2016] [Indexed: 01/03/2023] Open
Abstract
Leptospirosis is a zoonosis found worldwide that is caused by a spirochete. The main reservoirs of Leptospira, which presents an asymptomatic infection, are wild rodents, including the brown rat (Rattus norvegicus). Experimental studies of the mechanisms of its renal colonization in rats have previously used an intraperitoneal inoculation route. However, knowledge of rat-rat transmission requires the use of a natural route of inoculation, such as a mucosal or subcutaneous route. We investigated for the first time the effects of subcutaneous and mucosal inoculation routes compared to the reference intraperitoneal route during Leptospira infection in adult rats. Infection characteristics were studied using Leptospira renal isolation, serology, and molecular and histological analyses. Leptospira infection was asymptomatic using each inoculation route, and caused similar antibody production regardless of renal colonization. The observed renal colonization rates were 8 out of 8 rats, 5 out of 8 rats and 1 out of 8 rats for the intraperitoneal, mucosal and subcutaneous inoculation routes, respectively. Thus, among the natural infection routes studied, mucosal inoculation was more efficient for renal colonization associated with urinary excretion than the subcutaneous route and induced a slower-progressing infection than the intraperitoneal route. These results can facilitate understanding of the infection modalities in rats, unlike the epidemiological studies conducted in wild rats. Future studies of other natural inoculation routes in rat models will increase our knowledge of rat-rat disease transmission and allow the investigation of infection kinetics. Leptospirosis (infection with pathogenic Leptospira spp.) is a public health concern worldwide. The brown rat (Rattus norvegicus), as the most ubiquitous animal of urban wildlife, is potentially the primary source of Leptospira spp. for humans, dogs and livestock. For understanding the Leptospira maintenance in rat colonies, the experimental studies required the use of natural route of transmission between the rats. We investigated the effects of the mucosal and bite’s transmission (conjunctival-mucosal and subcutaneous routes) compared to the reference route (intraperitoneal) during infection in adult rats. With serology, we showed that the antibody production was independent of the inoculation route. By isolation, molecular and histological analyses, we found that the mucosal route was more efficient at renal colonization and leptospires excretion than the subcutaneous route. These results can be useful in understanding the infection modalities in rat that could prevent the human leptospirosis.
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Affiliation(s)
- Anne-Laure Zilber
- USC 1233 INRA/VAS, Equipe de Recherche sur la Leptospirose, Université de Lyon-VetAgro Sup, Marcy-l’Etoile, France
- * E-mail: (ALZ); (ZD)
| | - Patrick Belli
- UP Pathologie Morphologique et Clinique, Université de Lyon-VetAgro Sup, Marcy-l’Etoile, France
| | | | - Marc Artois
- USC 1233 INRA/VAS, Equipe de Recherche sur la Leptospirose, Université de Lyon-VetAgro Sup, Marcy-l’Etoile, France
| | - Angeli Kodjo
- USC 1233 INRA/VAS, Equipe de Recherche sur la Leptospirose, Université de Lyon-VetAgro Sup, Marcy-l’Etoile, France
- Laboratoire des Leptospires, Université de Lyon-VetAgro Sup, Marcy-l’Etoile, France
| | - Zoheira Djelouadji
- USC 1233 INRA/VAS, Equipe de Recherche sur la Leptospirose, Université de Lyon-VetAgro Sup, Marcy-l’Etoile, France
- Laboratoire des Leptospires, Université de Lyon-VetAgro Sup, Marcy-l’Etoile, France
- * E-mail: (ALZ); (ZD)
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Costa F, Wunder EA, De Oliveira D, Bisht V, Rodrigues G, Reis MG, Ko AI, Begon M, Childs JE. Patterns in Leptospira Shedding in Norway Rats (Rattus norvegicus) from Brazilian Slum Communities at High Risk of Disease Transmission. PLoS Negl Trop Dis 2015; 9:e0003819. [PMID: 26047009 PMCID: PMC4457861 DOI: 10.1371/journal.pntd.0003819] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2015] [Accepted: 05/08/2015] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND We address some critical but unknown parameters of individuals and populations of Norway rats (Rattus norvegicus) that influence leptospiral infection, maintenance and spirochetal loads shed in urine, which contaminates the environment ultimately leading to human infection. METHODOLOGY/PRINCIPAL FINDINGS Our study, conducted in Salvador, Brazil, established the average load of leptospires in positive kidneys to be 5.9 x 10(6) per mL (range 3.1-8.2 x10(6)) genome equivalents (GEq), similar to the 6.1 x 10(6) per ml (range 2.2-9.4 x10(6)) average obtained from paired urines, with a significant positive correlation (R2=0.78) between the two. Based on bivariate and multivariate modeling, we found with both kidney and urine samples that leptospiral loads increased with the age of rats (based on the index of body length to mass), MAT titer and the presence of wounding/scars, and varied with site of capture. Some associations were modified by sex but trends were apparent. Combining with data on the demographic properties and prevalence of leptospiral carriage in rat populations in Salvador, we estimated that daily leptospiral loads shed in the urine of a population of 82 individuals exceeded 9.1 x 10(10) leptospires. CONCLUSIONS/SIGNIFICANCE These factors directly influence the risk of leptospiral acquisition among humans and provide essential epidemiological information linking properties of rat populations with risk of human infection.
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Affiliation(s)
- Federico Costa
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Instituto de Saúde Coletiva, Universidade Federal da Bahia (UFBA), Salvador, Brazil
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
- Institute of Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - Elsio A. Wunder
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Daiana De Oliveira
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
| | - Vimla Bisht
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Gorete Rodrigues
- Centro de Controle de Zoonoses, Secretaria Municipal de Saúde, Ministério da Saúde, Salvador, Brazil
| | - Mitermayer G. Reis
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Albert I. Ko
- Centro de Pesquisas Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, Brazil
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Mike Begon
- Institute of Integrative Biology, University of Liverpool, Liverpool, United Kingdom
| | - James E. Childs
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
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Abstract
Human risks of acquiring a zoonotic disease from animals used in biomedical research have declined over the last decade because higher quality research animals have defined microbiologic profiles. Even with diminished risks, the potential for exposure to infectious agents still exists, especially from larger species such as nonhuman primates, which may be obtained from the wild, and from livestock, dogs, ferrets, and cats, which are generally not raised in barrier facilities and are not subject to the intensive health monitoring performed routinely on laboratory rodents and rabbits. Additionally, when laboratory animals are used as models for infectious disease studies, exposure to microbial pathogens presents a threat to human health. Also, with the recognition of emerging diseases, some of which are zoonotic, constant vigilance and surveillance of laboratory animals for zoonotic diseases are still required.
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Affiliation(s)
- James G. Fox
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Glen Otto
- Animal Resources Ctr University Texas Austin, Austin, TX, USA
| | - Lesley A. Colby
- Department of comparative Medicine University of Washington, Seattle, WA, USA
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Himsworth CG, Zabek E, Tang P, Parsons KL, Koehn M, Jardine CM, Patrick DM. Bacteria isolated from conspecific bite wounds in Norway and black rats: implications for rat bite-associated infections in people. Vector Borne Zoonotic Dis 2014; 14:94-100. [PMID: 24528094 DOI: 10.1089/vbz.2013.1417] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Bites associated with wild and domestic Norway and black rats (Rattus norvegicus and Rattus rattus) may have a variety of health consequences in people. Bite-related infections are among the most significant of these consequences; however, there is little data on the infectious agents that can be transmitted from rats to people through biting. This is problematic because without an accurate understanding of bite-related infection risks, it is difficult for health professionals to evaluate the adequacy of existing guidelines for empirical therapy. The objectives of this study were to increase our knowledge of the bacterial species associated with rat bites by studying bite wounds that wild rats inflict upon one another and to review the literature regarding rat bites and bite wound management. Wild Norway and black rats (n=725) were trapped in Vancouver, Canada, and examined for bite wounds in the skin. All apparently infected wounds underwent aerobic and anaerobic culture, and isolated bacteria were identified. Thirty-six rats had bite wound-related infections, and approximately 22 different species of bacteria belonging to 18 genera were identified. Staphylococcus aureus was the most common isolate; however, the majority of infections (72.5%) were polymicrobial. Rat bites can result in infection with a number of aerobic and anaerobic Gram-positive and Gram-negative bacteria. In humans, these wounds are best managed through early recognition and cleansing. The benefit of prophylactic antimicrobial treatment is debatable, but given the deep puncturing nature of rodent bites, we suggest that they should be considered a high risk for infection. Antibiotics selected should include coverage for a broad range of bacterial species.
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Affiliation(s)
- Chelsea G Himsworth
- 1 School of Population and Public Health, University of British Columbia , Vancouver, British Columbia, Canada
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7
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Abstract
The microbiology of animal bite wound infections in humans is often polymicrobial, with a broad mixture of aerobic and anaerobic microorganisms. Bacteria recovered from infected bite wounds are most often reflective of the oral flora of the biting animal, which can also be influenced by the microbiome of their ingested prey and other foods. Bacteria may also originate from the victim's own skin or the physical environment at the time of injury. Our review has focused on bite wound infections in humans from dogs, cats, and a variety of other animals such as monkeys, bears, pigs, ferrets, horses, sheep, Tasmanian devils, snakes, Komodo dragons, monitor lizards, iguanas, alligators/crocodiles, rats, guinea pigs, hamsters, prairie dogs, swans, and sharks. The medical literature in this area has been made up mostly of small case series or case reports. Very few studies have been systematic and are often limited to dog or cat bite injuries. Limitations of studies include a lack of established or inconsistent criteria for an infected wound and a failure to utilize optimal techniques in pathogen isolation, especially for anaerobic organisms. There is also a lack of an understanding of the pathogenic significance of all cultured organisms. Gathering information and conducting research in a more systematic and methodical fashion through an organized research network, including zoos, veterinary practices, and rural clinics and hospitals, are needed to better define the microbiology of animal bite wound infections in humans.
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Roczek A, Forster C, Raschel H, Hörmansdorfer S, Bogner KH, Hafner-Marx A, Lepper H, Dobler G, Büttner M, Sing A. Severe course of rat bite-associated Weil's disease in a patient diagnosed with a new Leptospira-specific real-time quantitative LUX-PCR. J Med Microbiol 2008; 57:658-663. [DOI: 10.1099/jmm.0.47677-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Leptospirosis is a zoonotic disease with global distribution, caused by spirochaetes of the genus Leptospira. Transmission of Leptospira interrogans serovar Icterohaemorrhagiae, the causative agent of Weil's disease, to humans usually results from exposure to the urine of infected, but mostly asymptomatic, rodents, either by direct contact or indirectly through contaminated soil or water. Although regarded as a re-emerging infectious disease, human leptospirosis is probably underdiagnosed due to its often unspecific clinical appearance and difficulties in culturing leptospires. Therefore, more rapid and specific diagnostic procedures are needed. Here we describe a novel real-time quantitative PCR system developed for the accurate and fast diagnosis of pathogenic Leptospira spp. Its usefulness in the management of a patient with rat bite-associated multiorgan failure is demonstrated.
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Affiliation(s)
- Alexandra Roczek
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Christian Forster
- Universitätsklinikum Erlangen, Medizinische Klinik 4, Krankenhausstraße 12, 91054 Erlangen, Germany
| | - Heribert Raschel
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Stefan Hörmansdorfer
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Karl-Heinz Bogner
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Angela Hafner-Marx
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Hans Lepper
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Gerhard Dobler
- Institute of Microbiology of the Bundeswehr, Neuherbergstraße 11, 80937 München, Germany
| | - Mathias Büttner
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
| | - Andreas Sing
- Bavarian Health and Food Safety Authority (LGL), Veterinärstraße 2, 85764 Oberschleißheim, Germany
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10
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Abstract
Leptospirosis is a worldwide zoonotic infection with a much greater incidence in tropical regions and has now been identified as one of the emerging infectious diseases. The epidemiology of leptospirosis has been modified by changes in animal husbandry, climate, and human behavior. Resurgent interest in leptospirosis has resulted from large outbreaks that have received significant publicity. The development of simpler, rapid assays for diagnosis has been based largely on the recognition that early initiation of antibiotic therapy is important in acute disease but also on the need for assays which can be used more widely. In this review, the complex taxonomy of leptospires, previously based on serology and recently modified by a genotypic classification, is discussed, and the clinical and epidemiological value of molecular diagnosis and typing is also evaluated.
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Affiliation(s)
- P N Levett
- University of the West Indies, School of Clinical Medicine & Research, and Leptospira Laboratory, Ministry of Health, Barbados.
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Saravanan R, Rajendran P, Thyagarajan SP, Smythe LD. First report of human leptospirosis due to Leptospira interrogans serovar javanica in India. Trans R Soc Trop Med Hyg 1998; 92:186. [PMID: 9764329 DOI: 10.1016/s0035-9203(98)90743-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Affiliation(s)
- R Saravanan
- Dr A. L. M. Post Graduate Institute of Basic Medical Sciences, Madras, India
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13
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Abstract
Epidemiological and clinical aspects of 50 consecutive patients, 47 adults and three children, hospitalized between 1977 and 1987 for human leptospirosis, were reviewed. 45 (90%) of the patients were from rural regions. 32 (64%) cases occurred in individuals at occupational risk for the infection. 35 (70%) cases were registered in the warm season. The source of infection was known in 34 (68%) cases. Weil's disease was diagnosed in 31 (62%) patients, aseptic meningitis in 12 (24%) and acute unexplained fever in seven (14%). Haemodialysis was required for 11 (35%) patients with Weil's disease. Three (6%) patients died. Cause of death was massive gastrointestinal haemorrhage in two and renal failure in one. Leptospira icterohaemorrhagiae was responsible for 39 (78%) cases, Leptospira canicola for six (12%), Leptospira grippotyphosa for two (4%), and Leptospira australis, Leptospira ballum and Leptospira sejroe, for one case each. A muscle biopsy was performed in six patients and a renal biopsy in three. Focal necrotic muscular changes, with mild mononuclear infiltrate, were found. Pigmented casts in distal convoluted tubules, mild interstitial inflammatory infiltrate and mesangial enlargement of some glomeruli were observed in kidney biopsies. A good knowledge of the protean clinical manifestations of leptospirosis and an accurate laboratory study are required for a correct diagnosis.
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Affiliation(s)
- H Lecour
- Department of Infectious Diseases, School of Medicine, Hospital S. João, Porto
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