Leptospirosis with transient paraparesis and thrombocytopenia: A case report

Abstract

Leptospirosis is the most widespread zoonosis in the world. We present an unusual case of leptospirosis in a 44-year-old man with severe thrombocytopenia and transient paraparesis. The diagnosis of leptospirosis was confirmed by blood nested polymerase chain reaction, seroconversion of Leptospira IgM and the microscopic agglutination test. Nerve conduction studies were suggestive of early polyneuropathy involving the right peroneal nerve and bilateral sural nerves. Peripheral nerve palsy is a potential clinical feature of leptospirosis.

Leptospirosis with Acute Liver Injury

“…Treatment of leptospirosis with antibiotics remains controversial (6). A Cochrane review of 7 randomized clinical trials was inconclusive on the role of antibiotics (penicillin) in leptospirosis, regardless of severity (7).…”

Recovery from Leptospira-Related Acute Liver Failure and Acute Kidney Injury ― A Case Report from Bangladesh

“…10 Treatment of leptospirosis with antibiotics remains controversial. 11 A Cochrane review of seven randomized clinical trials was inconclusive on the role of antibiotics (penicillin) in leptospirosis, regardless of severity. 12 Nearly 90% of cases are considered mild and oral doxycycline or amoxicillin may be used.…”

Avaliação do papel de duas proteínas de <i>Leptospira interrogans</i> na patogênese da leptospirose.

“…Deste modo, não fornecem proteção cruzada entre sorovares diferentes da preparação, uma vez que são os LPSs que definem os determinantes antigênicos de cada sorovar. Sendo assim, não induzem uma resposta de memória, necessitando de revacinação a cada 6-12 meses, (BHARTI et al, 2003;FAINE et al, 1997;HAAKE, 2000;LEVETT, 2001;SETE;RAPPUOLI, 2010 (GAMBERINI et al, 2005;RISTOW et al, 2007;YAN et al, 2009YAN et al, , 2010 (FAINE, 1999;WANG et al, 2012). Estudos têm demonstrado que as citocinas IL-1, IL-6, IL-8, IL-10 e IL-12, podem estas envolvidas nas respostas inflamatórias durante o processo infecioso de Leptospira, enquanto as TNF-α e IL-6, esão associadas com casos serveros e mortalidade por leptospirose (DE FOST et al, 2003;VERNEL-PAUILLAC et al, 2010).…”