Ince Nevin, Kilinçel Özge, Demirel-Gügül Tugba, Tanişman Işilay, Altun Gülşah
Düzce University Faculty of Medicine, Department of Infectious Diseases, Düzce, Turkey.
Düzce Atatürk State Hospital, Microbiology Laboratory, Düzce, Turkey.
Infez Med. 2020 Mar 1;28(1):91-97.
Leptospirosis is a ubiquitous acute bacterial zoonosis. This report describes six cases presenting to our hospital with symptoms such as fever and muscle pain and diagnosed as leptospirosis. All cases presented with fever, muscle pain, and lethargy and were engaged in activities such as farming, hunting, and fishing. Thrombocytopenia and impaired liver function tests were found in all patients, increased creatine-kinase in five, and increased creatinine in four. Leptospirosis was diagnosed using polymerase chain reaction (PCR). The course of the disease resulted in cure in three cases, chronic kidney disease sequelae in one, and death in two. In conclusion, the possibility of leptospirosis should be considered in patients presenting with non-specific symptoms such as fever and muscle pain and developing thrombocytopenia, and liver and kidney function disorder. Risk factors should also be investigated when taking histories. Early diagnosis and antibiotic therapy being started as quickly as possible are important in terms of the course of the disease.
钩端螺旋体病是一种普遍存在的急性细菌性人畜共患病。本报告描述了6例因发热和肌肉疼痛等症状前来我院就诊并被诊断为钩端螺旋体病的病例。所有病例均有发热、肌肉疼痛和嗜睡症状,且都从事农业、狩猎和捕鱼等活动。所有患者均出现血小板减少和肝功能检查异常,5例肌酸激酶升高,4例肌酐升高。采用聚合酶链反应(PCR)诊断钩端螺旋体病。病程导致3例治愈,1例出现慢性肾病后遗症,2例死亡。总之,对于出现发热和肌肉疼痛等非特异性症状且伴有血小板减少以及肝肾功能障碍的患者,应考虑钩端螺旋体病的可能性。问诊时还应调查危险因素。尽早进行早期诊断并尽快开始抗生素治疗对疾病病程至关重要。