La evidencia serológica de leptospirosis en pacientes con sospecha clínica de dengue en el estado de Ceará, Brasil

Bezerra, Laiane Fernanda de Melo; Fontes, Raissa Matos; Gomes, Almira Maria Monteiro; Silva, Dyana Alves da; Colares, Jeová Keny Baima; Lima, Danielle Malta

doi:10.7705/biomedica.v35i4.2504

Cited by 5 publications

(6 citation statements)

References 27 publications

(27 reference statements)

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“…Other studies in Malaysia have reported the prevalence of either dengue infection or leptospirosis infection and leptospirosis infection among dengue negative patients. The incidence of co-infection has also been documented in other countries such as India, Barbados, Mexico, Sri-Lanka, Jamaica and Brazil ranging from the year 2000-2015 [6–8, 13–21]. Of these studies, many are merely individual case–report based and only a countable number have reported concomitant leptospirosis and dengue infection in a specific population similar to our study.…”

Section: Discussionsupporting

confidence: 84%

“…We investigated the prevalence of concurrent dengue and leptospirosis infections among confirmed dengue patients and found a total of 11 cases (4.1%) while many other studies have reported only one to three individual cases or much lower prevalence compared to our study [6, 8, 13, 15, 16, 18, 20, 21, 37]. In addition, our findings may warrant further study to elucidate the occurrence of concurrent dengue and leptospirosis infection.…”

Section: Discussioncontrasting

confidence: 40%

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Clinical predictors of dengue fever co-infected with leptospirosis among patients admitted for dengue fever – a pilot study

Suppiah

Chan

et al. 2017

J Biomed Sci

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BackgroundDengue and leptospirosis infections are currently two major endemics in Malaysia. Owing to the overlapping clinical symptoms between both the diseases, frequent misdiagnosis and confusion of treatment occurs. As a solution, the present work initiated a pilot study to investigate the incidence related to co-infection of leptospirosis among dengue patients. This enables the identification of more parameters to predict the occurrence of co-infection.MethodTwo hundred sixty eight serum specimens collected from patients that were diagnosed for dengue fever were confirmed for dengue virus serotyping by real-time polymerase chain reaction. Clinical, laboratory and demographic data were extracted from the hospital database to identify patients with confirmed leptospirosis infection among the dengue patients. Thus, frequency of co-infection was calculated and association of the dataset with dengue-leptospirosis co-infection was statistically determined.ResultsThe frequency of dengue co-infection with leptospirosis was 4.1%. Male has higher preponderance of developing the co-infection and end result of shock as clinical symptom is more likely present among co-infected cases. It is also noteworthy that, DENV 1 is the common dengue serotype among all cases identified as dengue-leptospirosis co-infection in this study.ConclusionThe increasing incidence of leptospirosis among dengue infected patients has posed the need to precisely identify the presence of co-infection for the betterment of treatment without mistakenly ruling out either one of them. Thus, anticipating the possible clinical symptoms and laboratory results of dengue-leptospirosis co-infection is essential.

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Section: Discussionsupporting

confidence: 84%

Section: Discussioncontrasting

confidence: 40%

Clinical predictors of dengue fever co-infected with leptospirosis among patients admitted for dengue fever – a pilot study

Suppiah

Chan

et al. 2017

J Biomed Sci

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“…Libraty et al also reported that leptospirosis accounted for 19% of dengue suspected patients that tested negative for DENV [ 18 ]. Other studies have reported a lower prevalence of leptospirosis among dengue suspected patients ranging from 5 to 7.35% [ 28 , 29 ]. Moreover, it has been reported that many leptospirosis cases may go under recognized during dengue outbreaks [ 30 , 31 ].…”

Section: Main Textmentioning

confidence: 99%

Leptospirosis in febrile patients with suspected diagnosis of dengue fever

et al. 2021

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Objective This study was carried out to determine the prevalence of leptospirosis among febrile patients with a suspicious clinical diagnosis of dengue fever in northern Peru. Results A total of 276 serum samples from patients with acute febrile illness (AFI) and suspected diagnosis for dengue virus (DENV) were analyzed. We identified an etiological agent in 121 (47.5%) patients, DENV was detected in 30.4% of the cases, leptospirosis in 11.2% and co-infection by both pathogens was observed in 5.9% of the patients. In this study the most common clinical symptoms reported by the patients were: headache 89.1%, myalgias 86.9% and arthralgias 82.9%. No differences in symptomatology was observed among the different study groups.

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“…infections. In these studies, performed in many different countries, the DENV diagnoses were determined using: a) different anti-DENV IgM detection (ELISA or rapid lateral flow) assays (7–14), anti-DENV IgG detection (ELISA or rapid lateral flow) assays (8,10,11), DENV nonstructural-1 (NS1) glycoprotein detection (ELISA or rapid lateral flow) assays (11) , RT-PCRs (8-11,13), or DENV cell-culture isolation followed by DENV serotype detections (9) , while Leptospira spp. diagnoses were determined using: b) anti- Leptospira spp.…”

Section: Introductionmentioning

confidence: 99%

“…diagnoses were determined using: b) anti- Leptospira spp. IgM (ELISA or rapid lateral flow) assays (8,11–14), anti- Leptospira spp. IgG detection (ELISA or lateral flow) assays (11) , anti- Leptospira spp.…”

Section: Introductionmentioning

confidence: 99%

Dengue virus infected patients can generate false positives in the ‘gold standard’Leptospiraspp. microscopic agglutination test (MAT), immunofluorescence assays (IFAs), and immunoblot assays due to cross-reactive IgG and/or IgM antibodies against their outer surface membrane proteins

Falconar

Cuello-Pérez

Romero-Vivas

2023

Preprint

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There are overlapping world distributions of the mosquito-borne dengue viruses (DENVs) and the water-borne bacterial disease leptospirosis which cause large numbers of human infections and fatalities. As such, early differential diagnosis is required to then administer appropriate early leptospirosis antibiotic therapy or DENV patient supportive care, but co-infections have also been reported. In this study, using paired (S1: acute and S2: convalescent phase) patients' serum samples, we report that some DENV infected patients' IgG and/or IgM antibodies cross-reacted with 68-72 and 38-42 KDa outer surface membrane antigens of all Leptospira spp. serovars tested in immunoblot (western blot) assays and paraformaldehyde (cell-membrane impermeable fixative) treated Leptospira spp. in immunofluorescent assays (IFAs), as well as displayed a > 4-fold rise between their S1 and S2 serum samples in the 'gold standard' Leptospira spp. microscopic agglutination test (MAT). While DENV-1, -2 or -3 were isolated from their S1 sera, a) Leptospira spp. could not be isolated from them, b) their S1 sera were all PCR-negative using a Leptospira spp. gene target, and c) their S2 sera were all negative in a commercial anti-Leptospira spp. IgM ELISA. As such, we believe this is the first report of DENVs causing false positive reactions in the 'gold standard' Leptospira spp. MAT and with paraformaldehyde fixed Leptospira spp. serovars in IFAs as well as immunoblot (western blot) assays, and which needs further assessments using more DENV infected patients' serum samples and to identify these 68-72 and 38-42 KDa Leptospira spp. outer surface membrane antigens by proteomic analyses.

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La evidencia serológica de leptospirosis en pacientes con sospecha clínica de dengue en el estado de Ceará, Brasil

Cited by 5 publications

References 27 publications

Clinical predictors of dengue fever co-infected with leptospirosis among patients admitted for dengue fever – a pilot study

Clinical predictors of dengue fever co-infected with leptospirosis among patients admitted for dengue fever – a pilot study

Leptospirosis in febrile patients with suspected diagnosis of dengue fever

Dengue virus infected patients can generate false positives in the ‘gold standard’Leptospiraspp. microscopic agglutination test (MAT), immunofluorescence assays (IFAs), and immunoblot assays due to cross-reactive IgG and/or IgM antibodies against their outer surface membrane proteins

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