Atypical Cases of Leptospirosis: Insights From Georgia

Pathogenic Leptospira species are the source of leptospirosis, a common zoonotic infection that can cause a wide range of clinical manifestations, from minor flu-like symptoms to severe multiorgan failure. We present two peculiar cases of leptospirosis; they highlight the need for clinical awareness...

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Main Authors: Arash Ghani Dehkordi, Salah Rabea Salah Al-Tamary, Ashraf Rabea Salah Al-Tamary, Hamza Rabea Salah Al-Tamary, Shams Samih Ahmad Albarari, Alaaldin Mohammad Zeyad Assad, Ghena Mohammad Othman Hamdan, Ia Mikadze
Format: Article
Language:English
Published: Wiley 2024-01-01
Series:Case Reports in Infectious Diseases
Online Access:http://dx.doi.org/10.1155/2024/1414417
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author Arash Ghani Dehkordi
Salah Rabea Salah Al-Tamary
Ashraf Rabea Salah Al-Tamary
Hamza Rabea Salah Al-Tamary
Shams Samih Ahmad Albarari
Alaaldin Mohammad Zeyad Assad
Ghena Mohammad Othman Hamdan
Ia Mikadze
author_facet Arash Ghani Dehkordi
Salah Rabea Salah Al-Tamary
Ashraf Rabea Salah Al-Tamary
Hamza Rabea Salah Al-Tamary
Shams Samih Ahmad Albarari
Alaaldin Mohammad Zeyad Assad
Ghena Mohammad Othman Hamdan
Ia Mikadze
author_sort Arash Ghani Dehkordi
collection DOAJ
description Pathogenic Leptospira species are the source of leptospirosis, a common zoonotic infection that can cause a wide range of clinical manifestations, from minor flu-like symptoms to severe multiorgan failure. We present two peculiar cases of leptospirosis; they highlight the need for clinical awareness to improve patient outcomes and further knowledge of leptospirosis epidemiology and therapy by illuminating the difficulties in diagnosis and treatment. The first case involved a 30-year-old male presented with jaundice. Although he had no history of chronic illnesses, an exhaustive investigation was warranted due to his recent travel history and occupational contact. Laboratory tests revealed significantly increased levels of AST and ALT and positive Leptospira IgM serology. Remarkably, the patient refuted the traditional theory of leptospirosis transmission by denying direct animal interaction. After starting therapy with dexamethasone initially and adding doxycycline later, the patient’s condition significantly improved; his jaundice resolved and his liver enzyme levels returned to normal. An outpatient follow-up after discharge was advised to assess liver and kidney function. The second case involved an 87-year-old woman with a fever, weakness and hypertension. Investigations revealed hepatosplenomegaly, raising the possibility of hypersplenism. She reported exposure to animals, particularly her dogs in her urban house. Surprisingly, her AST and ALT levels were normal. Lab tests also revealed thrombocytopoenia with normal APTT and prolonged PT. Serological tests indicated positive Leptospira IgM. Along with intravenous infusions, the patient’s treatment plan comprised dexamethasone, enalapril and ceftriaxone to treat inflammation, hypertension and bacterial infection, respectively. Following a 20-day hospital stay, the patient’s laboratory results and symptoms improved, leading to her discharge. Continuous follow-up recommended to monitor her recovery and prevent recurrence. These case studies emphasise the significance of taking leptospirosis into account when treating patients who do not have normal exposure histories yet present with unusual symptoms.
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spelling doaj-art-e8524193b4ab4f478a3e898a955d58732025-08-20T02:06:44ZengWileyCase Reports in Infectious Diseases2090-66332024-01-01202410.1155/2024/1414417Atypical Cases of Leptospirosis: Insights From GeorgiaArash Ghani Dehkordi0Salah Rabea Salah Al-Tamary1Ashraf Rabea Salah Al-Tamary2Hamza Rabea Salah Al-Tamary3Shams Samih Ahmad Albarari4Alaaldin Mohammad Zeyad Assad5Ghena Mohammad Othman Hamdan6Ia Mikadze7Department of Infectious DiseasesDepartment of Infectious DiseasesDepartment of Infectious DiseasesDepartment of Infectious DiseasesDepartment of Infectious DiseasesDepartment of Infectious DiseasesDepartment of Infectious DiseasesDepartment of Infectious DiseasesPathogenic Leptospira species are the source of leptospirosis, a common zoonotic infection that can cause a wide range of clinical manifestations, from minor flu-like symptoms to severe multiorgan failure. We present two peculiar cases of leptospirosis; they highlight the need for clinical awareness to improve patient outcomes and further knowledge of leptospirosis epidemiology and therapy by illuminating the difficulties in diagnosis and treatment. The first case involved a 30-year-old male presented with jaundice. Although he had no history of chronic illnesses, an exhaustive investigation was warranted due to his recent travel history and occupational contact. Laboratory tests revealed significantly increased levels of AST and ALT and positive Leptospira IgM serology. Remarkably, the patient refuted the traditional theory of leptospirosis transmission by denying direct animal interaction. After starting therapy with dexamethasone initially and adding doxycycline later, the patient’s condition significantly improved; his jaundice resolved and his liver enzyme levels returned to normal. An outpatient follow-up after discharge was advised to assess liver and kidney function. The second case involved an 87-year-old woman with a fever, weakness and hypertension. Investigations revealed hepatosplenomegaly, raising the possibility of hypersplenism. She reported exposure to animals, particularly her dogs in her urban house. Surprisingly, her AST and ALT levels were normal. Lab tests also revealed thrombocytopoenia with normal APTT and prolonged PT. Serological tests indicated positive Leptospira IgM. Along with intravenous infusions, the patient’s treatment plan comprised dexamethasone, enalapril and ceftriaxone to treat inflammation, hypertension and bacterial infection, respectively. Following a 20-day hospital stay, the patient’s laboratory results and symptoms improved, leading to her discharge. Continuous follow-up recommended to monitor her recovery and prevent recurrence. These case studies emphasise the significance of taking leptospirosis into account when treating patients who do not have normal exposure histories yet present with unusual symptoms.http://dx.doi.org/10.1155/2024/1414417
spellingShingle Arash Ghani Dehkordi
Salah Rabea Salah Al-Tamary
Ashraf Rabea Salah Al-Tamary
Hamza Rabea Salah Al-Tamary
Shams Samih Ahmad Albarari
Alaaldin Mohammad Zeyad Assad
Ghena Mohammad Othman Hamdan
Ia Mikadze
Atypical Cases of Leptospirosis: Insights From Georgia
Case Reports in Infectious Diseases
title Atypical Cases of Leptospirosis: Insights From Georgia
title_full Atypical Cases of Leptospirosis: Insights From Georgia
title_fullStr Atypical Cases of Leptospirosis: Insights From Georgia
title_full_unstemmed Atypical Cases of Leptospirosis: Insights From Georgia
title_short Atypical Cases of Leptospirosis: Insights From Georgia
title_sort atypical cases of leptospirosis insights from georgia
url http://dx.doi.org/10.1155/2024/1414417
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