Leptospirosis and Coinfection: Should We Be Concerned?

Abstract

Pathogenic Leptospira is the causative agent of leptospirosis, an emerging zoonotic disease affecting animals and humans worldwide. The risk of host infection following interaction with environmental sources depends on the ability of Leptospira to persist, survive, and infect the new host to continue the transmission chain. Leptospira may coexist with other pathogens, thus providing a suitable condition for the development of other pathogens, resulting in multi-pathogen infection in humans. Therefore, it is important to better understand the dynamics of transmission by these pathogens. We conducted Boolean searches of several databases, including Google Scholar, PubMed, SciELO, and ScienceDirect, to identify relevant published data on Leptospira and coinfection with other pathogenic bacteria. We review the role of the host-microbiota in determining the synanthropic interaction of Leptospira sp. with other bacteria, thus creating a suitable condition for the leptospira to survive and persist successfully. We also discuss the biotic and abiotic factors that amplify the viability of Leptospira in the environment. The coinfection of leptospira with pathogenic bacteria has rarely been reported, potentially contributing to a lack of awareness. Therefore, the occurrence of leptospirosis coinfection may complicate diagnosis, long-lasting examination, and mistreatment that could lead to mortality. Identifying the presence of leptospirosis with other bacteria through metagenomic analysis could reveal possible coinfection. In conclusion, the occurrence of leptospirosis with other diseases should be of concern and may depend on the success of the transmission and severity of individual infections. Medical practitioners may misdiagnose the presence of multiple infections and should be made aware of and receive adequate training on appropriate treatment for leptospirosis patients. Physicians could undertake a more targeted approach for leptospirosis diagnosis by considering other symptoms caused by the coinfected bacteria; thus, more specific treatment could be given.

Double-trouble: A rare case of co-infection with melioidosis and leptospirosis from Sri Lanka

“…16 Both causative organisms are found in moist environments in soils with similar pH (6.5–7.3 for Leptospira and 6.5–7.5 for B. pseudomallei ). 17,18…”

“…16 Both causative organisms are found in moist environments in soils with similar pH (6.5-7.3 for Leptospira and 6.5-7.5 for B. pseudomallei). 17,18 Leptospirosis is transmitted to humans through direct or indirect contact with the urine of an infected animal. Leptospira so excreted can survive for months in fresh water, soil or mud.…”

Assessment of Serum Macrophage Migration Inhibitory Factor (MIF) as an Early Diagnostic Marker of Leptospirosis

“…Therefore, MIF was considered in this study to evaluate its diagnostic prospects. In general, the major problem in leptospirosis is its diagnosis, which is still mostly misleading due to the febrile-related symptoms of typhoid, dengue, malaria, hepatitis, enteritis, and shigellosis ( Gasem et al., 2020 ; Md-Lasim et al., 2021 ). In this study, our observations clearly stated that MIF ELISA has high sensitivity (100%) and specificity (>90%) for the diagnosis and distinction of leptospirosis cases from other febrile cases.…”

The diagnosis of leptospirosis complicated by pulmonary tuberculosis complemented by metagenomic next-generation sequencing: A case report

“…It is also obvious that pathogenic microorganisms involved in coinfections may induce similar clinical manifestations including fever, cough, headache, and myalgia, especially during early infection stages ( Bark et al., 2011 ; Md-Lasim et al., 2021 ). In fact, the overlapping spectrum of manifestations might not only be difficult for clinicians to distinguish between leptospirosis and its comorbidities, but might also be hard to differentiate from general infectious diseases, such as influenza and pneumonia.…”