Ocular and cutaneous manifestation of leptospirosis acquired in Albania: A retrospective analysis with implications for travel medicine

Puca, Edmond; Pilaca, Arben; Kalo, Tritan; Pipero, Pellumb; Bino, Silvia; Hysenaj, Zhenisa; Abazaj, Erjona; Gega, Arjet; Petrela, Elizana; Kraja, Dhimitër

doi:10.1016/j.tmaid.2015.11.011

Cited by 24 publications

(29 citation statements)

References 13 publications

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“…Admittedly, the patient did not have any rashes, which makes some of these agents less likely and actually not many cases of Influenza are seen in September. On the other hand, early fall is the time of the year when most of leptospirosis cases are seen in Albania [6]. Our patient comes from the region of Saranda, which is not one of the endemic areas, but has been the origin of some reported cases.…”

Section: Discussionmentioning

confidence: 88%

“…Leptospirosis can be asymptomatic, present as a flu-like disease or could manifest as a severe form with systemic involvement of kidneys, liver, lungs, heart, pancreas, eyes. The more severe form of the disease is known as Weil's disease, and can carry significant mortality risk [2][3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…The Mediterranean-tropical climate with humid summer and fall favors spreading of leptospirosis. The majority of cases are seen between April-September [6]. In general, rainfall, flooding, urbanization, and outdoor recreation are important emerging risk factors [2].…”

Section: Discussionmentioning

confidence: 99%

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Acute encephalitis as initial presentation of leptospirosis

Puca¹,

Majko²,

Puca

et al. 2017

J Infect Dev Ctries

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Encephalitis is an acute inflammation of the brain matter, very often associated with viral infections, but it can also be caused by non-viral pathogens such as leptospirosis. Leptospirosis is a systemic disease caused by bacteria of the Leptospira genus. Leptospiral infection has a broad spectrum of clinical manifestations ranging from subclinical or mild illness to a fulminant life-threatening illness. In this case report we describe a young patient from Southern Albania with isolated encephalitis caused by Leptospira, where acute encephalitis was the initial presentation of the disease.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

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Acute encephalitis as initial presentation of leptospirosis

Puca¹,

Majko²,

Puca

et al. 2017

J Infect Dev Ctries

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“…This explains why in the second case the patient developed mild anterior uveitis as she was treated with systemic antibiotics earlier on. In 1866, leptospiral uveitis was first reported by Weil and is thought to be a late autoimmune process (Puca et al 2016;Rathinam et al 2015).…”

Section: Discussionmentioning

confidence: 99%

“…According to Puca et al 2016, conjunctival swelling usually appears on the third or fourth day. In our second patient, she developed conjunctiva swellings on the fourth day of admission, which is a week after the onset of illness.…”

Section: Discussionmentioning

confidence: 99%

Conjunctiva Granuloma, a Rare Presentation of Ocular Leptospirosis Presenting as Conjunctiva Granuloma: Case Series

Yin¹

2018

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ABSTRAKDiagnosis okular leptospirosis adalah mencabar dan memerlukan penelitian sejarah terhadap infeksi leptospira terdahulu di samping sokongan kajian makmal yang baik. Siri kes ini melaporkan dua orang wanita muda dengan keradangan granuloma lapisan konjuntiva, dan dalam pengetahuan kami, merupakan dua kes pertama yang dilaporkan tentang leptospirosis okular dengan granuloma konjuntiva. Diagnosa definitif leptospira okular dibuat berdasarkan keputusan ujian makmal, di mana biopsi konjuntiva bagi kedua-dua pesakit tersebut menunjukkan positif DNA leptospira. Mengimbas kembali, kedua-dua pesakit mempunyai pendedahan terhadap organisma leptospira. Kesimpulannya, diagnosa leptospira okular memerlukan penelitian klinikal yang tinggi dan perlu disokong oleh ujian makmal.Kata kunci: infeksi okular, leptospirosis, manifestasi mata ABSTRACT Diagnosis of ocular leptospirosis is challenging and requires a high index of suspicion of previous leptospiral infection and good laboratory support. This case series focuses on two young females with unilateral conjunctiva granuloma. To the best of our knowledge, these are the first two cases of ocular leptospirosis with conjunctiva granuloma. The definitive diagnosis of ocular leptospirosis was based on laboratory studies in which conjunctival biopsies in these two cases showed positive leptospira DNA. Retrospectively, the history was suggestive as both

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Management of Travel-Related Infectious Diseases in the Emergency Department

Throckmorton

Hancher

2020

Curr Emerg Hosp Med Rep

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Purpose of Review Emergency physicians generally have limited exposure to internationally acquired illnesses. However, travelers can present quite ill, and delays in recognition and treatment can lead to increased morbidity and mortality. This paper aims to summarize typical presentations of common international diseases and provide the emergency physician with a practical approach based on current guidelines. Recent Findings In the treatment of traveler's diarrhea, azithromycin has become the treatment of choice due to the growing antibiotic resistance. Intravenous artesunate was approved in 2019 under investigational new drug protocol for the treatment of severe malaria, and artemisinin-based combination therapies (ACTs) have become the first-line treatment for most cases of uncomplicated malaria. Since the 2015 outbreak, Zika has become a concern to many travelers, but the current treatment is supportive. Summary Clinicians should be aware of a few noteworthy updates in the treatment of internationally acquired illnesses, but more importantly, they must recognize warning signs of severe illness and treat promptly. Future research on workup and disposition could help emergency physicians identify which patients need admission in well-appearing febrile travelers.

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Ocular and cutaneous manifestation of leptospirosis acquired in Albania: A retrospective analysis with implications for travel medicine

Cited by 24 publications

References 13 publications

Acute encephalitis as initial presentation of leptospirosis

Acute encephalitis as initial presentation of leptospirosis

Conjunctiva Granuloma, a Rare Presentation of Ocular Leptospirosis Presenting as Conjunctiva Granuloma: Case Series

Management of Travel-Related Infectious Diseases in the Emergency Department

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