ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health)-Universitat de Barcelona, Barcelona, Spain.
Department of International Health, Hospital Universitario Virgen de la Salud, Toledo, Spain.
Travel Med Infect Dis. 2018 May-Jun;23:77-79. doi: 10.1016/j.tmaid.2018.02.013. Epub 2018 Mar 8.
Leptospirosis is an important zoonosis worldwide, nevertheless is often poor recognized in non tropical settings. In Thailand is becoming an emerging disease and Chiang Mai could become a popular spot to acquire the disease amongst travelers.
We describe three cases of imported leptospirosis undifferentiated fever after travelling to Thailand during the summer of 2015 diagnosed at two Spanish hospitals.
Our three patients probably acquired leptospirosis while swimming in freshwater around Chiang Mai, a Thailand's northern region with moderate incidence of leptopirosis. Travelers had normal white blood cell counts and low platelets, suggesting leptospirosis after ruling out other imported diseases such as malaria, dengue or typhoid.
As recent findings point out, low platelets and normal white blood cell counts are clinical features that could help the clinician to suspect Leptospirosis infection. It should be always considered as a cause of fever, particularly if travelers come from a tropical country and have had contact with water or flooding, especially during rainy season.
钩端螺旋体病是一种重要的全球动物源性传染病，但在非热带地区常被漏诊。在泰国，该病正逐渐成为一种新出现的疾病，清迈可能会成为旅行者感染该病的热门地点。
我们描述了 3 例 2015 年夏季前往泰国旅行后，在西班牙的两家医院诊断出的不明原因发热性钩端螺旋体病。
我们的 3 例患者可能是在清迈附近的淡水中游泳时感染了钩端螺旋体病，清迈是泰国北部地区，钩端螺旋体病的发病率中等。旅行者的白细胞计数正常，血小板计数较低，提示在排除疟疾、登革热或伤寒等其他输入性疾病后可能为钩端螺旋体病。
正如最近的研究结果指出的，血小板计数低和白细胞计数正常是有助于临床医生怀疑钩端螺旋体病感染的临床特征。如果旅行者来自热带国家，并接触过水或洪水，特别是在雨季，那么应始终将其作为发热的原因之一进行考虑。
