A rare case of severe leptospirosis infection presenting as septic shock in a non-endemic area: a case report and literature review
- Resource Type
- article
- Authors
- Junjie Dai; Can Yao; Huaxiang Ling; Binbin Li; Rongchang Chen; Fei Shi
- Source
- BMC Infectious Diseases, Vol 23, Iss 1, Pp 1-5 (2023)
- Subject
- Leptospirosis
Thrombocytopenia
Acute febrile illnesses
Differential diagnosis
Infectious and parasitic diseases
RC109-216
- Language
- English
- ISSN
- 1471-2334
Abstract 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.