A Case of Leptospira Ards- “Obsession with COVID-19 Leading to Delayed Diagnosis of Common Disease

Tendulkar, Prakash; Sharma, Divanshee; Bairwa, Mukesh; Kant, Ravi

doi:10.3844/ajidsp.2021.61.64

Cited by 3 publications

(4 citation statements)

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“…Gardening, although it may not have a high association with leptospirosis, in some cases can be the only background, as was reported in one case [14,37]. The remaining two cases, working as a farmer and living in a farmers' village were the only antecedents that helped to reach the diagnosis of leptospirosis; performing different farming activities have already been reported to be significant risk factors for leptospirosis [18,22,38,39]. Orthohantaviruses are negative-stranded RNA viruses classified into two major groups which cause hemorrhagic fever with renal syndrome (HFRS) or hantavirus cardiopulmonary syndrome [40].…”

Section: N Discussionmentioning

confidence: 81%

“…All of them developed febrile respiratory illness, which may have led to misdiagnosis; however, in one case [14], jaundice was also developed, which helped to diagnose leptospirosis. In three cases, laboratory parameters included at least two of the following: kidney failure features, liver damage features, and thrombocytopenia, which can also indicate leptospirosis [14,18,22,35]. Contact with rodents or their excreta is the leading risk factor for acquiring the disease; however, other environmental, occupational, and recreational activities may also generate a risk for human infection [36].…”

Section: N Discussionmentioning

confidence: 99%

“…Doxycycline was administered, but the clinical condition worsened, and the patient died during the hospital stay. After, the Leptospira IgM test came out, showing positive results, which were more than twice the normal value [18].…”

Section: Casesmentioning

confidence: 97%

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Infezioni in Medicina

2023

Infez Med

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COVID-19 is a zoonotic coronavirus disease caused by SARS-CoV-2. Its fast spreading by aerosol transmission has made it a highly contagious disease, causing the most recent 2020 pandemic. Although it mainly affects the respiratory system, atypical forms of the disease have been described, including developing an undifferentiated febrile illness without respiratory symptoms, that can represent a diagnostic challenge, mainly in tropical areas where several zoonotic febrile diseases are circulating. Thus, despite the broad clinical spectrum of COVID-19, in the tropics, other zoonotic etiologies should always be considered as differential diagnoses. According to our case reports review, eight different zoonotic febrile diseases misdiag-nosed as COVID-19 have been reported in the available scientific literature of four databases. These were only suspected due to the epidemiological history. Thus, making a complete and detailed clinical history of a febrile patient in the tropics is essential to suspect the etiology and request the necessary confirmatory tests. Therefore, COVID-19 must be included as a differential diagnosis of undifferentiated febrile illness in the tropics, but other zoonotic infectious diseases must not be ruled out.

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Section: N Discussionmentioning

confidence: 81%

Section: N Discussionmentioning

confidence: 99%

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Infezioni in Medicina

2023

Infez Med

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“…Thus, the treating physician should keep in mind all these rare complications and infectious conditions, which will ultimately help him in reaching the correct diagnosis. 11,12 The IgM antibody usually appears in the serum of infected individuals around the fifth to tenth day of the onset of Leptospirosis. The presence of a specific IgM antibody in a patient's sample indicates a recent infection.…”

Section: Discussionmentioning

confidence: 99%

Changing Trends in the Seroprevalence of Leptospirosis in Kelambakkam: A Ten-Year Retrospective Study

Shanmugam

2022

JCD

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Introduction: Leptospirosis is a zoonotic infection affecting humans. The main sources of infection are animal reservoir hosts and man is the accidental host in the disease transmission process. The diagnosis is usually made by microscopy, culture, molecular techniques, and serological tests like ELISA, MAT (Microscopic Agglutination Test) and MSAT (Macroscopic Slide Agglutination Test). The ELISA method to detect IgM antibodies is used as a good cost-effective testing method. An increasing titre of IgM antibody is a sign of active leptospirosis. Aims and Objectives: The study aimed to evaluate the seroprevalence of Leptospirainfection over a 10-year period in a tertiary care hospital located in Kelambakkam village in Chengalpattu district. Material and Method: The samples were tested for the presence of specific Leptospira IgM antibodies in the patient’s serum using the Panbio Leptospira IgM ELISA kit. The samples were reported as positive/ negative/ equivocal accordingly. Results: This retrospective study included a total of 2035 patients, clinically suspected of leptospirosis, over a 10-year period from 2011 to 2021. 186 patients tested positive for specific IgM antibodies by ELISA method,giving an overall prevalence rate of 9.14%. Conclusion: The seroprevalence of leptospirosis over a time period of more than 10 years is highlighted in our study. Clinical suspicion of leptospirosis should be kept in mind at all times, especially now during the COVID-19 pandemic. The Panbio Leptospira IgM ELISA test kit used in our study proves to be a very useful method for diagnostic purposes, especially in limited-resource settings.

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Epidemiological determinants of leptospirosis in rural and urban districts of Maharashtra, India

Kembhavi¹,

Velhal²,

Shah³

2021

J Family Med Prim Care

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Background: Leptospirosis is emerging as one of the growing public health problems in many parts of India. It can occur in both rural and urban areas with varied risk factors. This study was taken up in three districts of Maharashtra namely—Mumbai, Ratnagiri, and Sindhudurg to understand the determinants of leptospirosis in both the urban and rural areas and look for differences if any. Materials and Methods: This cross-sectional study was carried out during the year 2017. A pretested validated questionnaire was used to collect data. Field observations were made. Eighty-seven cases from Sindhudurg and 14 from Ratnagiri and 307 cases from Mumbai were included in the study. Results: A total of 408 cases were included in the study. A total of 63 (62.4%) were males and 38 (37.6%) were females. Most cases belonged to the 20–35 year age group (37%). In rural areas, 32.7% of them visited government facilities first, whereas, in the urban areas, it was 73.9% ( P = 0.006). Headache, myalgia, and prostration were more common in cases from rural areas ( P = <0.05). Skin rash was found to be associated with urban cases of leptospirosis. The presence of rodents, cattle sheds, pets, and working in paddy fields were common environmental risks in rural areas, and using water for recreational activities were common in urban areas ( P < 0.001). Conclusions: Context-specific risk factors were found significantly associated with the cases. No important difference was found in the epidemiology of leptospirosis in the urban and rural areas except the source of infection.

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A Case of Leptospira Ards- “Obsession with COVID-19 Leading to Delayed Diagnosis of Common Disease

Cited by 3 publications

References 4 publications

Infezioni in Medicina

Infezioni in Medicina

Changing Trends in the Seroprevalence of Leptospirosis in Kelambakkam: A Ten-Year Retrospective Study

Epidemiological determinants of leptospirosis in rural and urban districts of Maharashtra, India

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