Shimizu Yukiko, Sakamoto Naoya, Ainoda Yusuke, Hikone Mayu, Kobayashi Kenichiro, Iwabuchi Sentaro, Koizumi Nobuo, Ohnishi Kenji
Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, 4-23-15, Koto-bashi, Sumida-ku, Tokyo 130-8575, Japan.
Department of Emergency Medicine, Tokyo Metropolitan Bokutoh General Hospital, 4-23-15, Koto-bashi, Sumida-ku, Tokyo 130-8575, Japan; Department of Infectious Diseases, Tokyo Women's Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
J Infect Chemother. 2014 Apr;20(4):278-81. doi: 10.1016/j.jiac.2013.10.012. Epub 2013 Dec 11.
Leptospirosis is not a major disease in urban areas of Japan. We describe a 49-year-old man with leptospirosis, who lived in an urban area and had no history of living in endemic area of leptospirosis. As he worked at a fish market infested with rats, he was suspected of having contracted leptospirosis and received antimicrobial agent treatment. Serum and urinary tests confirmed the diagnosis of leptospirosis. Although it took six days from the onset until treatment initiation, the patient improved in response to receiving ceftriaxone for seven days. Analyzing past reports of Japanese patients with leptospirosis who had no history of overseas travel, we identified 90 patients with courses similar to that of our patient, and the period from onset to treatment initiation was about six days on average (described in 46 cases). Health care providers as well as patients need to recognize that even people with no history of being in an endemic area of leptospirosis may still be at risk of developing this disease depending on occupations and activities.
