Acute encephalitis as initial presentation of leptospirosis

Puca, Edmond; Majko, Joana; Puca, Entela; Qyra, Elda; Gega, Arjet; Pipero, Pellumb

doi:10.3855/jidc.8613

Cited by 11 publications

(9 citation statements)

References 11 publications

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“…Seroepidemiological surveys carried out by the Institute of Public Health (IPH) in the period 1980-1990 in Albania have demonstrated a predominant circulation of species, Leptospira Pomona and Leptospira ichterohaemorrhagica [11]. The majority of cases are seen between April to September [3,32].The incidence of leptospirosis has shown a tendency to increase secondary to global demographic changes, climates changes, natural catastrophes and floods [33]. The risk of leptospirosis in Albania during the rainy season becomes higher after flooding that accompanies natural disasters when the human population may be exposed to water contaminated with urine from infected animals.…”

Section: Discussionmentioning

confidence: 99%

“…People on rural area were the most affected ones with the 68.4% of total cases. Based on their profession, 63.5% of the patients were farmers, 10.1% fishermen, 7,2% were drivers or auto repair mechanics, and the rest employed in miscellaneous jobs (construction worker or municipal, retired and unemployed) [3,11,32,37,38]. Exposure to animals could be a potential risk factor for the disease.…”

Section: Discussionmentioning

confidence: 99%

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The role of gender in the prevalence of human leptospirosis in Albania

Puca¹,

Pipero²,

Harxhi³

et al. 2018

J Infect Dev Ctries

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Introduction: Leptospirosis is a zoonotic spirochetal disease with global importance, which continues to have a major impact on public health in developing countries. The prevalence of the disease is much higher in males. The objectives of this study were: to give some data and to share our experience with human leptospirosis in Albania; to describe the prevalence regarding to the role of gender in the prevalence of human leptospirosis; to make a gender specific analysis of the clinical manifestations in patients diagnosed and treated for leptospirosis in our service and to make a review of literature related to this hypothesis. Methodology: We reviewed the epidemiologic data, risk factors and differences in clinical presentation between males and females’ patients with leptospirosis. These data are analysed from hospitalized patients. Diagnosis of leptospirosis was established based on clinical presentation, epidemiological data and subsequently confirmed serologically by Anti-Leptospira IgM antibodies through ELISA test. Results: Between 2005-2016, 233 cases of confirmed leptospirosis were analysed. Males were 208 (89.27%) and 25 of patients (10.72%) were females in ratio 9:1 p < 0.001. The highest prevalence was observed in the 45-64 age groups. Overall mortality was found to be 8.58%, 19 were males and one female p < 0.001. Conclusions: There is a much higher prevalence of leptospirosis in middle aged men. Mortality rate seems to be similar in males and females. While the difference in prevalence may be related to exposure to risk factors, further investigation is necessary to study gender-based genetic and immunological predisposition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The role of gender in the prevalence of human leptospirosis in Albania

Puca¹,

Pipero²,

Harxhi³

et al. 2018

J Infect Dev Ctries

Self Cite

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“…In a similar case reported by Puca and Majko,7 an 18-year-old female from Southern Albania presented with symptoms of fever, headache, photophobia, vomiting and generalised myalgia. Physical examination did not show any focal neurological deficits or signs of meningeal irritation.…”

Section: Discussionmentioning

confidence: 51%

Behavioural change: a rare presentation of leptospirosis

Tomacruz¹,

Sandejas

Berba

et al. 2019

BMJ Case Rep

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Neurological manifestations of leptospirosis without severe multiorgan involvement are a rare clinical entity. Despite the increasing prevalence of the disease in many tropical countries, its protean clinical presentations make its timely diagnosis challenging. We report the case of a 44-year-old Filipino man presenting with fever, myalgia, behavioural changes and altered sensorium. Neurological examination did not show any focal neurological deficits or clear signs of meningoencephalitis. Lumbar tap, cranial CT scan and cranial MRI were inconclusive. The diagnosis of leptospirosis with acute encephalitis relied heavily on the patient’s clinical clues, appropriate exposure history and patterns in ancillary laboratory tests. Empiric antibiotic therapy with ceftriaxone was initiated. Seroconversion and fourfold increase in serological antibody titres by leptospirosis microagglutination test later confirmed the diagnosis. The patient was successfully treated, and all neurological complications were reversed.

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“…Neuro-leptospirosis occurs in around 10-15% of patients [5]. Aseptic meningoencephalitis is the most common neurological manifestation [6], but cases of myeloradiculopathy, myelopathy, and Guillain Barre syndrome have also been reported. Cerebellar involvement has also been described and is thought to a ect less than 5% of cases [7].…”

Section: Discussionmentioning

confidence: 99%

Liver Transplantation for Acute Liver Failure Attributed to Leptospirosis: A Report of Two Cases

Lebreton

Aubrun

Mabrut

et al. 2019

Case Reports in Critical Care

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Background. Leptospirosis is a zoonosis caused by pathogenic spirochetes of the genus Leptospira. Although it may be limited to nonspecific fever, leptospirosis may also be responsible for neurological symptoms or fulminant diseases such as Weil’s disease. Diagnosis is challenging due to the difficulty in isolating the organism and the delays required for performing the serological test. Case Presentation. Two cases of leptospirosis are presented here. The clinical picture differed from a real Weil’s disease in the first case and from a neuro-leptospirosis in the second. However, both patients underwent liver transplantation because of the severity of the associated acute liver failure. Unfortunately, one of the cases had a fatal outcome. Conclusion. Antibiotic treatment for leptospirosis should not be delayed by the lack of a positive serology test for this potentially lethal disease. In the context of a history of exposure to risk factors for leptospirosis, a negative serology must be repeated 7 days to 2 weeks following the first test. Although not always present, acute liver injury may, in rare cases, require liver transplantation.

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Acute encephalitis as initial presentation of leptospirosis

Cited by 11 publications

References 11 publications

The role of gender in the prevalence of human leptospirosis in Albania

The role of gender in the prevalence of human leptospirosis in Albania

Behavioural change: a rare presentation of leptospirosis

Liver Transplantation for Acute Liver Failure Attributed to Leptospirosis: A Report of Two Cases

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