Travel Clinic, Clinique Saint-Pierre, Ottignies, Belgium.
J Travel Med. 2013 Jul-Aug;20(4):228-31. doi: 10.1111/jtm.12035. Epub 2013 May 15.
Leptospirosis belongs to the spectrum of travel-related infections.
We retrospectively studied all the consecutive cases of travel-related leptospirosis seen in our department between January 2008 and September 2011. Patients were included with a clinical picture compatible with the disease within 21 days after return, the presence of a thermoresistant antigen or IgM antibodies, Elisa ≥ 1 /400, and a positive microagglutination test (MAT) ≥ 1/100.
Fifteen leptospirosis cases were evaluated. Exposure occurred in Asia (47%), Africa (20%), the Caribbean (20%), and Indian Ocean (13%). Fourteen patients were infected during water-related activities. On admission the most frequent symptoms were fever (100%), headache (80%), and digestive disorders (67%). Relevant laboratory findings included impaired liver function tests (100%), lymphocytopenia (80%), thrombocytopenia (67%), and elevated C-reactive protein (CRP) (67%). Our cases were confirmed by MAT that found antibodies against nine different serovars. Seven patients were cured with amoxicillin, four with doxycycline, two with ceftriaxone, one with ceftriaxone, doxycycline, and spiramycin, whereas one recovered spontaneously (retrospective diagnosis). Eight patients were hospitalized. All patients recovered.
Our cases involved nine different serovars. They were related to travel in Asia, Africa, and the Caribbean. Bathing or other fresh-water leisure activities (canoeing, kayaking, rafting) are the most likely at-risk exposure. Any traveler with fever and at-risk exposure should be investigated for leptospirosis.
钩端螺旋体病属于旅行相关感染的范畴。
我们回顾性研究了 2008 年 1 月至 2011 年 9 月期间在我们科室就诊的所有连续的旅行相关钩端螺旋体病病例。患者符合以下标准：疾病发生在返回后 21 天内，有耐热抗原或 IgM 抗体，Elisa≥1/400，且微量凝集试验（MAT）阳性，≥1/100。
共评估了 15 例钩端螺旋体病患者。暴露于亚洲（47%）、非洲（20%）、加勒比地区（20%）和印度洋（13%）。14 例患者在与水有关的活动中感染。入院时最常见的症状是发热（100%）、头痛（80%）和消化系统紊乱（67%）。相关的实验室检查结果包括肝功能检查异常（100%）、淋巴细胞减少（80%）、血小板减少（67%）和 C 反应蛋白（CRP）升高（67%）。我们的病例通过 MAT 确诊，发现了针对 9 种不同血清型的抗体。7 例患者用阿莫西林治愈，4 例用强力霉素治愈，2 例用头孢曲松治愈，1 例用头孢曲松、强力霉素和螺旋霉素治愈，而 1 例则自行恢复（回顾性诊断）。8 例患者住院治疗。所有患者均痊愈。
我们的病例涉及 9 种不同的血清型。它们与亚洲、非洲和加勒比地区的旅行有关。洗澡或其他淡水休闲活动（划船、皮划艇、漂流）是最有可能的高危暴露。任何有发热和高危暴露的旅行者都应进行钩端螺旋体病的检查。
