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A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review

BACKGROUND: Leptospirosis is a zoonosis caused by spirochete “genus” leptospira. The clinical presentations of leptospirosis range from an influenza-like presentation of fever and myalgia, to severe forms. Leptospirosis can potentially lead to a misdiagnosis or delay in diagnosis when clinical simil...

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Autores principales: Dai, Junjie, Yao, Can, Ling, Huaxiang, Li, Binbin, Chen, Rongchang, Shi, Fei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391985/
https://www.ncbi.nlm.nih.gov/pubmed/37525113
http://dx.doi.org/10.1186/s12879-023-08367-w
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author Dai, Junjie
Yao, Can
Ling, Huaxiang
Li, Binbin
Chen, Rongchang
Shi, Fei
author_facet Dai, Junjie
Yao, Can
Ling, Huaxiang
Li, Binbin
Chen, Rongchang
Shi, Fei
author_sort Dai, Junjie
collection PubMed
description BACKGROUND: Leptospirosis is a zoonosis caused by spirochete “genus” leptospira. The clinical presentations of leptospirosis range from an influenza-like presentation of fever and myalgia, to severe forms. Leptospirosis can potentially lead to a misdiagnosis or delay in diagnosis when clinical similarities exist. CASE PRESENTATION: A 63-year-old man presented with fever, shock and thrombocytopenia followed by diffuse pulmonary hemorrhage. Peripheral blood Metagenomic Next-generation Sequencing (mNGS) reported Leptospira interrogans. The patient was treated with piperacillin-tazobactam (TZP) plus doxycycline and improved dramatically after 7 days. CONCLUSION: We conclude that leptospirosis can potentially lead to a misdiagnosis or delay in diagnosis. Correctly evaluation of thrombocytopenia in acute febrile illnesses facilitates the differential diagnosis of leptospirosis. mNGS can accurately detect Leptospira DNA during the early stage of the infection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-023-08367-w.
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spelling pubmed-103919852023-08-02 A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review Dai, Junjie Yao, Can Ling, Huaxiang Li, Binbin Chen, Rongchang Shi, Fei BMC Infect Dis Case Report BACKGROUND: Leptospirosis is a zoonosis caused by spirochete “genus” leptospira. The clinical presentations of leptospirosis range from an influenza-like presentation of fever and myalgia, to severe forms. Leptospirosis can potentially lead to a misdiagnosis or delay in diagnosis when clinical similarities exist. CASE PRESENTATION: A 63-year-old man presented with fever, shock and thrombocytopenia followed by diffuse pulmonary hemorrhage. Peripheral blood Metagenomic Next-generation Sequencing (mNGS) reported Leptospira interrogans. The patient was treated with piperacillin-tazobactam (TZP) plus doxycycline and improved dramatically after 7 days. CONCLUSION: We conclude that leptospirosis can potentially lead to a misdiagnosis or delay in diagnosis. Correctly evaluation of thrombocytopenia in acute febrile illnesses facilitates the differential diagnosis of leptospirosis. mNGS can accurately detect Leptospira DNA during the early stage of the infection. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-023-08367-w. BioMed Central 2023-07-31 /pmc/articles/PMC10391985/ /pubmed/37525113 http://dx.doi.org/10.1186/s12879-023-08367-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Dai, Junjie
Yao, Can
Ling, Huaxiang
Li, Binbin
Chen, Rongchang
Shi, Fei
A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review
title A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review
title_full A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review
title_fullStr A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review
title_full_unstemmed A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review
title_short A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review
title_sort rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391985/
https://www.ncbi.nlm.nih.gov/pubmed/37525113
http://dx.doi.org/10.1186/s12879-023-08367-w
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