An interesting presentation of leptospirosis
Keywords:Leptospirosis, Haemorrhage, SDH, Thrombocytopenia
Leptospirosis is a zoonotic infection more common in south India. Most of the cases are asymptomatic but rarely patient can develop complications like renal failure, acute liver failure, pancreatitis, ARDS and bleeding diathesis. Haemorrhage has been reported in multiple sites, of which the most common is pulmonary haemorrhage. Here we report a case of 53-year-old male presenting with acute febrile illness and seizures. CT brain revealed subdural hemorrhage (SDH). He also had thrombocytopenia with elevated liver and renal parameters and elevated Lipase levels. CT abdomen revealed features of acute pancreatitis. Here we encounter a rare case of leptospirosis presenting with subdural haemorrhage and pancreatitis.
Haake DA, Levett PN. Leptospirosis in humans. Curr Top Microbiol Immunol. 2015;387:65-97.
Ahmed A, Grobusch MP, Klatser PR, Hartskeerl RA. Molecular approaches in the detection and characterization of Leptospira. J Bacteriol Parasitol. 2012;3:1000133.
Reis EA, Hagan JE, Ribeiro GS, Teixeira-Carvalho A, Martins-Filho OA, Montgomery RR et al. Cytokine response signatures in disease progression and development of severe clinical outcomes for leptospirosis. PLoS Negl Trop Dis. 2013;7:e2457.
Arean VM. The pathologic anatomy and pathogenesis of fatal human leptospirosis (Weil’s disease). Am J Pathol. 1962;40:393-423.
Shivakumar S, Shareek P. Diagnosis of leptospirosis utilizing modified Faine's criteria. J Asso Physicians India. 2004;52:678-9.
Holla R, Darshan B, Pandey L, Unnikrishnan B, Kumar N, Thapar R et al. Leptospirosis in Coastal South India: A Facility Based Study. Biomed Res Int. 2018;2018:1759125.
Becirovic A, Numanovic F, Dzafic F, Piljic D. Analysis of Clinical and Laboratory Characteristics of Patients with Leptospirosis in Five-year Period. Mater Sociomed. 2020;32(1):15-19.
Niloofa R, Fernando N, de Silva NL, Karunanayake L, Wickramasinghe H, Dikmadugoda N et al. Diagnosis of Leptospirosis: Comparison between Microscopic Agglutination Test, IgM-ELISA and IgM Rapid Immunochromatography Test. PLoS One. 2015;10(6):e0129236.
Alian S, Davoudi A, Najafi N, Ghasemian R, Ahangarkani F, Hamdi Z. Clinical and laboratory manifestation and outcome of icterohemorrhagic leptospirosis patients in Northern Iran. Med J Islam Repub Iran. 2015;29:308.
Estcourt LJ, Stanworth SJ, Collett D. Intracranial haemorrhage in thrombocytopenic haematology patients-a nested case-control study: the InCiTe study protocol. BMJ Open. 2014;4:e004199.
Kaya E, Dervisoglu A, Eroglu C, Polat C, Sunbul M, Ozkan K. Acute pancreatitis caused by leptospirosis: report of two cases. World J Gastroenterol. 2005;11(28):4447-9.