Atypical Renal Presentation in Severe Leptospirosis

Małecki, Michał; Gołembiewska, Edyta; Muraszko, Anna Maria; Fiecek, Beata; Lewandowska, Magda; Urasińska, Elżbieta; Stępniewska, Joanna; Fijałkowski, Maciej; Ciechanowski, Kazimierz

doi:10.1016/j.ekir.2018.08.007

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…In our patient, the most difficult clinical problems to deal with were renal failure and thrombocytopenia. Figure 2 shows the increase in leukocytes next to the decrease in platelets, as reported in the medical history timeline, which strengthens our position that treatment based on doxycycline (1, 2, 7) and apheresis (10) was needed urgently. This proved to be a decisive factor in our patient's improvement; plasma apheresis is helpful in eliminating the excess of microorganisms and inflammatory cells, and is a common treatment indicated for cases of multi-organ failure (11,12).…”

Section: Be Taken As An Indication Of a Co-infection Becausesupporting

confidence: 78%

Severe Leptospirosis in a Mexican Woman

Balderrama-Carmona

Cadena-Orea

Sanchez-Arteaga

et al. 2020

ama

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Objective. To describe a severe case of infection by Leptospira in a woman in the northwest of Mexico.Case report. A 55-yearold woman from Sonora, Mexico arrived at the Intensive Care Unit due to severe multiple organ failure primarily affecting the respiratory, renal and hepatic systems. Diagnostic tests were performed, and they were positive for anti-Leptospira antibodies, IgM and IgG; and spirochetes were observed on dark field microscopy and confirmed by Polymerase Chain Reaction (PCR). Doxycycline and platelet apheresis transfusion were used as treatment, which led to a very slow recovery.Conclusion. The information presented in this study may help in the identification of pathology caused by spirochetes. This case report is the first to present a case of severe leptospirosis in Sonora, Mexico.

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Section: Be Taken As An Indication Of a Co-infection Becausesupporting

confidence: 78%

Severe Leptospirosis in a Mexican Woman

Balderrama-Carmona

Cadena-Orea

Sanchez-Arteaga

et al. 2020

ama

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“…Systemic infections can show similar features as acute thrombotic microangiopathy (TMA) with some reports of leptospirosis-induced TMA [1,2]. A TMA (TTP/HUS) registry showed 7% of patients presented with features of TMA were subsequently diagnosed with a systematic infection [1].…”

Section: Discussionmentioning

confidence: 86%

“…Leptospirosis is a common tropical zoonotic infection, but its incidence in the Republic of Ireland (ROI) is less than 0.4/100,000 population. In its fulminant form, leptospirosis can present with multiorgan failure, pulmonary haemorrhage, acute liver injury, acute kidney injury (AKI), and haematological abnormalities being a prominent feature which may overlap with other disorders such as TTP [2]. e reported kidney biopsy findings in leptospirosis-associated AKI suggest acute interstitial nephritis (AIN) with acute tubular injury as being the most common histopathological lesion [3].…”

Section: Introductionmentioning

confidence: 99%

Leptospirosis Presenting with Features of Thrombotic Microangiopathy

Ebad

Moollan

Ahmed

et al. 2020

Case Reports in Nephrology

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Leptospirosis is an exceptionally rare infectious disease in the Republic of Ireland. Leptospirosis can present with or mimic thrombotic microangiopathies (TTP/HUS). A 48-year-old male presented to a peripheral hospital with a short history of diarrhoea, anaemia, hyperbilirubinemia, raised lactate dehydrogenase, thrombocytopenia, and severe acute kidney injury and was transferred to our tertiary care kidney centre. A form of acute thrombotic microangiopathy (TMA) was suspected. However, no schistocytes were seen on the blood film, and the reticulocyte count was depressed. A kidney biopsy was performed before initiating any potential treatment which revealed acute interstitial nephritis (AIN). Leptospirosis was considered and subsequently serologically confirmed. The patient was managed with antimicrobials and supportive therapy. Acute kidney injury is common in leptospirosis and is often due to AIN. Initial presentation can mimic TMA; however, a differential diagnosis of leptospirosis should be considered even in nonendemic areas due to re-emergence of the disease.

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Atypical Renal Presentation in Severe Leptospirosis

Cited by 2 publications

References 7 publications

Severe Leptospirosis in a Mexican Woman

Severe Leptospirosis in a Mexican Woman

Leptospirosis Presenting with Features of Thrombotic Microangiopathy

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