Leptospirosis in suspected cases of dengue in Jamaica, 2002–2007

Abstract

Due to overlapping clinical features with other febrile illnesses, the diagnosis of leptospirosis is often overlooked, resulting in delay in treatment and increased mortality. In this study the prevalence of leptospirosis was determined in 590 patients with dengue-like illnesses using the Leptospira IgM dipstick and dengue enzyme-linked immunosorbent assays. Leptospira IgM antibodies were found in 27 (5.0%) patients. Dengue IgM negative (6.9% versus 2.5%, P < 0.05) and dengue IgG positive patients (8.0% versus 3.5%, P < 0.01) were more likely to be leptospira IgM positive. Fever, skin rash, central nervous system and respiratory involvement were the most common presenting features. The presence of arthralgia (P = 0.016), hepatitis (P = 0.000), jaundice (P = 0.003), splenomegaly (P = 0.041) and haematuria (P = 0.029) were associated with leptospirosis. In countries with an endemicity of leptospirosis and dengue it is important that patients with dengue-like illnesses, especially those with no serological evidence of current primary dengue infection, be investigated for leptospirosis.

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

“…Brown, et al, assessed 590 patients suspected of dengue infection of whom 314 showed positive results for serological tests for dengue and 27 were positive for leptospirosis (14). In this study, five (5.8%) of the 86 patients with clinical suspicion of dengue were positive for leptospirosis.…”

“…Although the number of patients with leptospirosis was small, our results corroborate those of Brown, et al's study. The leptospirosis-positive results of the five patients with initial suspicion of dengue suggested that, in the state of Ceará, confusion in clinical diagnosis might be occurring due to the similarity (12,14).…”

“…The clinical features of leptospirosis can be confused with those of dengue, especially during epidemic periods of the latter, when diagnosis can only be confirmed by clinical and epidemiological criteria (6,14). Brown, et al, assessed 590 patients suspected of dengue infection of whom 314 showed positive results for serological tests for dengue and 27 were positive for leptospirosis (14).…”

Seroprevalence of Seven Zoonotic Pathogens in Pregnant Women from the Caribbean

“…1,2 Other studies have identified dengue virus (a mosquito-borne arbovirus) and leptospirosis as emerging health problems. [3][4][5][6] Limited cases of zoonotic hepatitis E virus (HEV) infection have been documented but only preliminary characterization has been performed. 7 The objective of this study was to examine the seroprevalence of seven zoonotic agents among individuals residing in 10 Caribbean countries.…”

Fatal Pulmonary Haemorrhage in Co-infection with Dengue and Leptospirosis

“…In addition, co-infection cases are not uncommon. A study conducted in Jamaica showed that 2.5% of the 314 dengue IgM positive samples were also positive for leptospirosis infection (Brown et al 2010). In another study conducted by Kumar et al (2012), coinfection of dengue and leptospirosis was confirmed in 1.3% of 1,309 cases where both dengue and leptospirosis were investigated.…”