Three cases of anicteric leptospirosis from Turkey: mild to severe complications
Abstract number: 1134_04_180
Erdinc F.S., Koruk S.T., Hatipoglu C.A., Kinikli S., Demiroz A.P.
Leptospirosis is a worldwide zoonosis and among patients ill with leptospirosis, 90% have the milder anicteric form of the disease. Presumptive diagnosis may be based on the microscopic agglutination test used for determination of antibody titre and tentative identification of serotype. Three cases with positive Leptospira microagglutination titre (MAT) to L australis var bratislava and positive urinary IFAT are presented here.
A 71-year-old male patient living in rural area admitted with fever, nausea, myalgia, coughing and diarrhoea. Laboratory studies revealed decreased platelet count (60000/mm3), increased blood urea, creatinine, AST and ALT. Ceftriaxone was started with the diagnosis of pneumonia. MAT was positive at 1:400. After 2 weeks, the patient was discharged with no evidence of his illness.
A 55-year-old female patient living in rural area admitted with fever, headache, nausea, vomiting, nuchal rigidity and lumbar pain. Laboratory studies revealed decreased platelet count (44000/mm3), and increased blood urea, creatinine, AST, ALT, and CPK. CSF analysis revealed pleocytosis with 140/mm3 and normal levels of glucose and protein. MAT was positive at 1:400. The patient transferred to the intensive care unit and with deteriorated respiratory and neurological findings she died on the third day of admission despite ceftriaxone therapy.
A 32-year-old female patient with a history of travel to a rural area presented with fever, headache, nausea, vomiting, nuchal rigidity, artralgia and myalgia. Laboratory studies revealed the platelet count of 90000/mm3 and increased blood urea, creatinine, ALT and CPK levels. CSF analysis revealed pleocytosis with 180/mm3 and normal levels of glucose and protein. Combination therapy with ceftriaxone and acyclovir was started. MAT was positive at 1:200. The patient was discharged from the hospital without any complication on the tenth day of admission.
Our first case admitted with clinical presentation of pneumonia and two cases presented with aseptic meningitis. There are reported cases of icteric leptospirosis with thrombocytopenia and acute renal failure from Turkey. The three cases presented here had thrombocytopenia and acute renal failure as complication of anicteric leptospirosis. One of the cases had fatal outcome but could not be strictly correlated with leptospirosis.
|Session name:||XXIst ISTH Congress|
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