Centre Hospitalier Andrée Rosemon, Service de Réanimation Polyvalente, Cayenne, French Guiana.
Institut Pasteur, Centre National de Référence de la Leptospirose, Biology of Spirochetes Unit, Paris, France.
J Infect Public Health. 2020 Aug;13(8):1181-1183. doi: 10.1016/j.jiph.2020.03.020. Epub 2020 Apr 16.
Leptospirosis is a zoonotic disease with worldwide distribution. In French Guiana, a French overseas department of South America, this bacterial infection is endemic with the increase of human cases since the last 5 years. Nevertheless, the epidemiological data on the circulating infecting strain remains scarce due to the lack of specific symptoms and the used diagnostic approaches. We report a severe case of leptospirosis in a 52-years-old male, working as a street cleaner, hospitalized at the Intensive Care Unit of city capital hospital of French Guiana because of hemodynamic, neurological, renal, and respiratory failure. At ICU admission, the patient was comatose, his temperature was 37.3°C, heart rate 104 beats per minute, blood pressure 84/45mmHg, and oxygen saturation 95% while under mechanical ventilation. Retrospective exploration using molecular and serological approaches from the samples allowed reporting an infection by Leptospira santarosai serogroup Sejroe serovar Hardjo. To our knowledge, this is the first human case infected with this species in French Guiana. Through these analyses, this report provides new epidemiological information about the Leptospira strains circulating in French Guiana. In particular, this emphasizes the importance of accurate diagnosis to characterize with more precision the circulating Leptospira strains in this department.
钩端螺旋体病是一种具有全球分布的人畜共患病。在法属圭亚那，这一南美洲的法国海外省，这种细菌感染是地方性的，自过去 5 年来，人类病例有所增加。然而，由于缺乏特异性症状和使用的诊断方法，关于循环感染菌株的流行病学数据仍然很少。我们报告了一名 52 岁男性的严重钩端螺旋体病病例，该男性是一名街道清洁工，因血流动力学、神经、肾脏和呼吸衰竭而住进法属圭亚那首府医院的重症监护病房。在入住 ICU 时，患者昏迷，体温为 37.3°C，心率 104 次/分钟，血压 84/45mmHg，机械通气下血氧饱和度为 95%。使用分子和血清学方法对样本进行回顾性探索，报告了一种由 Leptospira santarosai 血清群 Sejroe 血清型 Hardjo 引起的感染。据我们所知，这是法属圭亚那首例感染该物种的人类病例。通过这些分析，本报告提供了有关法属圭亚那循环钩端螺旋体菌株的新流行病学信息。特别是，这强调了准确诊断的重要性，以便更精确地描述该省的循环钩端螺旋体菌株。
