Aug 2026· Jurnal Locus Penelitian dan Pengabdian· Vol 5, pp. 6614-6623· 0 citations
TL;DR
The patient was diagnosed with severe leptospirosis (Weil's disease) complicated by acute kidney injury and bronchopneumonia, and received intravenous ceftriaxone antibiotic therapy, hemodialysis, and supportive management, with subsequent clinical and laboratory improvement.
Abstract
Leptospirosis is a bacterial zoonotic disease caused by spirochetes of the genus Leptospira and belongs to the group of Neglected Tropical Diseases that often go undiagnosed, particularly in areas with a history of flooding. This case report presents a 20-year-old man who presented with a five-day history of weakness prior to hospital admission, accompanied by persistent fever, nausea, vomiting with every meal, and dizziness, with a history of repeated flood exposure in his residential environment. Physical examination revealed a generally ill appearance, bilateral icteric sclera, anemic conjunctiva, and jaundice of the skin. Laboratory findings showed progressive leukocytosis, thrombocytopenia, mild anemia, hyponatremia, hypokalemia, and elevated urea and creatinine levels that improved during treatment, as well as hyperbilirubinemia with a cholestatic pattern and mild elevations in SGOT/SGPT. Serological testing for Leptospira yielded positive results, while HBsAg, Anti-HCV, and HIV tests were negative. Chest radiography demonstrated findings consistent with bronchopneumonia, while abdominal ultrasonography showed increased cortical echogenicity of both kidneys suggestive of a chronic process, accompanied by cystitis and bilateral pleural effusion. The patient was diagnosed with severe leptospirosis (Weil's disease) complicated by acute kidney injury and bronchopneumonia, and received intravenous ceftriaxone antibiotic therapy, hemodialysis, and supportive management, with subsequent clinical and laboratory improvement. This case underscores the importance of maintaining early clinical suspicion for leptospirosis in patients with a history of flood exposure, given that delayed diagnosis and management are closely associated with a worsening prognosis.
We report the case of a 50-year-old man admitted to the emergency department with fever, asthenia, and diarrhea, who developed multiorgan failure and acute respiratory distress syndrome (ARDS) due to a massive, abrupt-onset alveolar hemorrhage secondary to leptospirosis infection. Leptospirosis is a zoonosis mainly transmitted by rats, with an increasing incidence in Belgium and the rest of Western Europe. The wide spectrum of symptoms and variability in disease severity make this diagnosis particularly challenging. In this case, initial serological testing, including the microscopic agglutination test (MAT), was negative, leading to a diagnostic delay despite a severe clinical presentation, and the diagnosis was only confirmed after repeated MAT testing. This clinical case describes a severe presentation and highlights the importance of thorough history-taking, including information provided by the patient's relatives, together with repeated etiological testing when clinical suspicion persists. Following intensive care management, the patient showed progressive clinical improvement and was ultimately discharged from the intensive care unit and from the hospital.
Alexis Loulas, T. Tran, Virginie Meurant· Cureus· 0 citations
Leptospirosis is a zoonotic bacterial infection caused by pathogenic Leptospira species and remains a major public health concern in tropical and subtropical regions. Early clinical manifestations are often nonspecific and resemble other acute febrile illnesses, leading to delayed diagnosis and treatment. Severe leptospirosis may develop even in young and previously healthy individuals, resulting in significant morbidity and mortality. An 18-year-old male presented with acute-onset fever, severe arthralgia, nausea, and vomiting. He had a history of environmental exposure, including frequent flooding around his residence and the presence of rodents. Physical examination revealed fever, conjunctival injection, and jaundice. Laboratory findings showed thrombocytopenia, acute kidney injury, and marked hyperbilirubinemia with mildly elevated transaminases. Serological testing for Leptospira IgM was positive, confirming the diagnosis. Abdominal ultrasonography demonstrated no biliary obstruction or structural liver abnormalities. The patient was treated with intravenous ceftriaxone, adequate fluid resuscitation, and close monitoring of renal function. Clinical and laboratory improvements were observed, and the patient was discharged in stable condition after six days of hospitalization. This case highlights that severe leptospirosis can occur in adolescents and young adults without comorbidities. Recognition of environmental risk factors, early diagnosis, and prompt initiation of appropriate antimicrobial and supportive therapy are crucial to prevent severe complications. Increased clinical awareness is essential to improve outcomes in leptospirosis-endemic areas.
Scrub typhus is an important cause of acute undifferentiated febrile illness in children residing in endemic regions of India. Its diagnosis is often challenging because of non-specific clinical manifestations and the absence of classicalsigns such as eschar. We report the case of a 12-year-old boy from Northeast India who presented with persistent high grade fever, generalized weakness, and reduced oral intake. Clinical examination revealed mild bilateral pedal edemawithout rash, eschar, hepatosplenomegaly, or neurological abnormalities. Initial empirical treatment with intravenousceftriaxone failed to produce significant clinical improvement. Further evaluation demonstrated elevated inflammatorymarkers and positive Scrub Typhus Immunoglobulin M serology, confirming the diagnosis. The child was treated withintravenous doxycycline 65 mg twice daily, followed by oral doxycycline, resulting in rapid defervescence and markedclinical recovery within 48 h. This case highlights the importance of maintaining a high index of suspicion for scrubtphus in children presenting with prolonged fever in endemic areas, even in the absence of classical clinical findings.Early diagnosis and timely initiation of doxycycline therapy are essential for preventing severe complication and ensuring favorable outcomes.
Unknown authors· Indian Journal of Case Repor...· 0 citations
This case underlines the importance of considering brucellosis in febrile patients with livestock exposure, even in non-endemic settings, and presents a rare and severe respiratory form of brucellosis in a patient with occupational exposure to livestock.
Ondrej Zahornacký, Š. Porubčin, Alena Rovňáková et al.· The Egyptian Journal of Inte...· 0 citations
Background: Mediterranean spotted fever , caused by Rickettsia conorii, is an endemic tick-borne zoonosis in the Mediterranean region. Although the disease is usually self-limiting, severe forms complicated by septic shock and multiple organ dysfunction syndrome are uncommon and potentially life-threatening. Early recognition and prompt initiation of doxycycline are crucial to improve outcomes.
Case Presentation: We report the case of a 61-year-old man with poorly controlled type 2 diabetes mellitus (HbA1c 10%) who presented with a 15-day history of fever, generalized maculopapular rash, and progressive confusion. On admission, he was febrile (39°C) and in septic shock with hypotension, tachycardia, oliguria, and a Glasgow Coma Scale score of 13/15. Physical examination revealed a characteristic inoculation eschar in the right gluteal region. Laboratory investigations showed marked systemic inflammation, thrombocytopenia, acute kidney injury, hepatocellular injury with cholestasis, hyperlactatemia, and coagulation abnormalities. Serological testing by indirect immunofluorescence assay detected anti-Rickettsia conorii IgG antibodies. The diagnosis of severe Mediterranean spotted fever complicated by septic shock and multiple organ dysfunction syndrome (SOFA score: 10) was established. The patient received intravenous crystalloids, norepinephrine, doxycycline, ciprofloxacin, methylprednisolone, insulin therapy, gastric protection, and venous thromboembolism prophylaxis. His clinical course was favorable, with progressive resolution of organ dysfunction, successful discontinuation of vasopressor support, and transfer to the Infectious Diseases Department.
Conclusion: This case highlights that Mediterranean spotted fever should be considered in the differential diagnosis of septic shock associated with fever, rash, and an inoculation eschar in endemic areas. Early diagnosis, prompt doxycycline therapy, and timely intensive care management are essential for improving patient outcomes
Hicham Hammadi, A. Elbouti, Hamza Madouim et al.· MedPeer publisher· 0 citations
Brucellosis commonly manifests with fever, arthralgia, and hepatosplenomegaly, whereas severe cholestatic hepatitis is exceedingly rare. We report a 54‐year‐old goat farmer who presented with a 4‐day history of right upper quadrant tenderness, progressive jaundice, and generalized pruritus after consuming unpasteurized milk from his own herd, with which he also had daily close contact. Examination showed scleral icterus and mild lethargy without peritoneal signs. Laboratory investigation revealed profound, predominantly conjugated hyperbilirubinemia (total 25.1 mg/dL, direct 23 mg/dL) with a cholestatic enzyme pattern (alkaline phosphatase 565 U/L, gamma‐glutamyl transferase 225 U/L; R factor 0.4) and only mild transaminase elevation, together with acute kidney injury, thrombocytopenia with an elevated mean platelet volume and no platelet aggregates, hypofibrinogenemia, a markedly elevated D‐dimer, and scant schistocytes. Thrombotic microangiopathy was initially considered, but a positive direct antiglobulin test, overt coagulopathy, and absent reticulocytosis favored sepsis‐associated disseminated intravascular coagulation, confirmed by an International Society on Thrombosis and Haemostasis score of 6. Marked hyperferritinemia prompted consideration of hemophagocytic lymphohistiocytosis, which was not substantiated. Cross‐sectional abdominal imaging excluded mechanical obstruction and showed hepatosplenomegaly with subcentimeter splenic nodules and no hepatic focal lesions. Brucella melitensis grew from all three blood cultures, and Wright agglutination was positive at a titer of 1/160. Echocardiography excluded endocarditis, and magnetic resonance imaging excluded spondylodiscitis. Continuous venovenous hemodiafiltration was required for life‐threatening uremia, and doxycycline plus rifampin was administered for 6 weeks, with near‐complete biochemical normalization by the end of treatment. Brucellosis should be considered in patients with animal exposure who present with severe cholestatic jaundice and multiorgan involvement, since prompt combination antimicrobial therapy can achieve full recovery.
Unknown authors· Case Reports in Infectious D...· 0 citations
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