Leptospirosis in Febrile Patients: Diagnosis by Serology and Polymerase Chain Reaction

Perwez, Khalid; Vb, Suman; Kumar, Nayanatara Arun; Hussain, Mohammad Asif

doi:10.5296/jbls.v2i1.535

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…However, we confirmed only two leptospirosis cases using EMJH culture media throughout Bangladesh for a period of one year. The earlier studies were based on highly sensitive serological tests [ 41 – 43 ], so our culture-based approach underestimated the contribution of Leptospira to the burden of febrile illness in these hospitals.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical presentation of Rickettsia, Coxiella, Leptospira, Bartonella and chikungunya virus infections among hospital-based febrile patients from December 2008 to November 2009 in Bangladesh

et al. 2017

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BackgroundWe conducted a study to identify Rickettsia, Coxiella, Leptospira, Bartonella, and Chikungunya virus infections among febrile patients presenting at hospitals in Bangladesh.MethodsWe collected blood samples from patients at six tertiary hospitals from December 2008 to November 2009 and performed laboratory tests at the United States Centers for Disease Control and Prevention (CDC).ResultsOut of 720 enrolled patients, 263 (37%) were infected with Rickettsia; 132 patients had immunofluorescence antibody titer >64 against spotted fever, 63 patients against scrub typhus fever and 10 patients against typhus fever. Ten patients were identified with Coxiella. We isolated Leptospira from two patients and Bartonella from one patient. Ten patients had antibodies against Chikungunya virus. The proportion of patients who died was higher with rickettsial fever (5%) compared to those without a diagnosis of rickettsial infection (2%). None of the patients were initially diagnosed with rickettsial fever.ConclusionsRickettsial infections are frequent yet under-recognized cause of febrile illness in Bangladesh. Clinical guidelines should be revised so that local clinicians can diagnose rickettsial infections and provide appropriate drug treatment.

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Section: Discussionmentioning

confidence: 99%

Prevalence and clinical presentation of Rickettsia, Coxiella, Leptospira, Bartonella and chikungunya virus infections among hospital-based febrile patients from December 2008 to November 2009 in Bangladesh

et al. 2017

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“…Perwez et al reported that PCR was superior in the first week of illness to ELISA IgM, Figure 2. Geographical distribution of cases included in this study but a low positivity was observed from the 8th day, and during 13 -15 days, ELISA IgM was superior to PCR (24).…”

Section: Discussionmentioning

confidence: 68%

“…The positivity of SAT and ELISA IgM for all 67 sera was 48 (71.6%) and 39 (58.2%), respectively. In the case of the unavailability of the reference serology test (MAT), ELISA IgM and SAT can detect leptospirosis at the acute and convalescent stages, with high sensitivity as reported (2,4,19,23,24). Therefore, we suggest that patients who had negative results by ELISA IgM and SAT might have not leptospirosis.…”

Section: Discussionmentioning

confidence: 79%

First Real-Time PCR in Morocco for Human Leptospirosis Using TaqMan Probes Targeting the LipL32 Gene

Al-orry

Arahou

Hassikou

et al. 2019

Arch Clin Infect Dis

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Background: Currently, qPCR has been used as a rapid diagnostic method for human leptospirosis. Previous studies have indicated that qPCR has high sensitivity in the early days of the illness. Objectives: The aim of this study was to evaluate qPCR as a diagnostic method for human leptospirosis in the National Institute of Hygiene, Rabat, Morocco. Methods: From 2004 to 2016, 67 sera related to 67 patients with clinical signs mimic to leptospirosis were sent to the laboratory of Bacteriology for routine diagnosis and confirmation. SAT, ELISA IgM, ELISA IgG, and qPCR were used for the diagnosis. Results: High positivity was observed by SAT (88.24%), ELISA IgM (58.82%), and real-time PCR (17.64%), in sequence. No negative results by serological tests had positive results by real-time PCR. Forty-six patients were males (68.68%) and 21 were females (31.34%). The high incidence observed was from Sidi Qacem (40%). Conclusions: SAT and ELISA IgM are useful for the diagnosis of human leptospirosis in Morocco and they can provide prompt and low-cost diagnosis, especially when resources are limited.

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Serological Evaluation of Clinically Suspected Leptospirosis Cases in a Tertiary Care Hospital

Ramanath¹,

Karnaker²

2020

jemds

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BACKGROUND Leptospirosis is a zoonotic infection caused by the spirochaete Leptospira, which has worldwide distribution. Laboratory diagnosis is routinely performed by serological tests like dipstick assay, lateral flow assay and latex agglutination which are rapid tests recommended for screening the disease. Microscopic Agglutination Test (MAT) is the standard test for serological diagnosis of leptospiral infection which is not included in the test panel in most of the peripheral laboratories as the procedure is laborious and it requires to maintain live leptospira. Therefore, one of the rapid tests is routinely employed for demonstration of leptospiral antibodies. Our objective was to screen the acute cases of leptospirosis by Leptochek WB IgM and PanBio IgM Elisa and compare the findings with the MAT and correlate the clinical findings with the serological tests. METHODS This study was conducted in a tertiary care hospital in Mangalore from August 2010 to September 2013. A total of 314 cases of clinically suspected leptospirosis were included based on the Faine's criteria. Patients' serum was screened for leptospiral antibodies by Leptochek WB IgM, PanBio IgM ELISA and Microscopic Agglutination Test (MAT). RESULTS Out of 314 clinically suspected cases screened, seropositivity for leptospirosis by Leptochek WB-IgM, PanBio IgM ELISA and MAT was found to be 49 (15.6%), 65 (20.7%) and 78 (24.8%) respectively. Thus, an overall prevalence rate of leptospirosis was 24.8% (78/314) based on the MAT test. Sensitivity, specificity, positive predictive value and negative predictive value of Leptocheck WB IgM was 53.8%, 97%, 85.7 and 86.4% with MAT while the comparative values of PanBio-ELISA IgM with respect to MAT test was 74.5%, 97 %, 89.2% and 92% respectively. Common clinical features among MAT positive cases were fever, chills and rigors, oliguria, vomiting, jaundice and headache. CONCLUSIONS MAT is a standard serological test for Leptospirosis. This test is not always available for peripheral health centres, as the test is time consuming and cumbersome. Thus, screening tests are now being employed for screening the patients. Rapid tests like Leptocheck-WB can be supplemented with an ELISA test for screening of clinically suspected cases of Leptospirosis and later confirmed with the MAT at reference centres.

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Leptospirosis in Febrile Patients: Diagnosis by Serology and Polymerase Chain Reaction

Cited by 3 publications

References 13 publications

Prevalence and clinical presentation of Rickettsia, Coxiella, Leptospira, Bartonella and chikungunya virus infections among hospital-based febrile patients from December 2008 to November 2009 in Bangladesh

Prevalence and clinical presentation of Rickettsia, Coxiella, Leptospira, Bartonella and chikungunya virus infections among hospital-based febrile patients from December 2008 to November 2009 in Bangladesh

First Real-Time PCR in Morocco for Human Leptospirosis Using TaqMan Probes Targeting the LipL32 Gene

Serological Evaluation of Clinically Suspected Leptospirosis Cases in a Tertiary Care Hospital

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