acyclovir and Leptospirosis

Leptospirosis is a zoonotic illness caused by pathogenic spirochetes of the genus Leptospira. The disease spectrum ranges from a mild influenza-like presentation to a more serious Weil's syndrome. Leptospirosis rarely presents as a primary neurological syndrome. We report two cases of Leptospira borgpetersenii serovar Tarasssovi presenting as aseptic meningitis in Sri Lanka.. We describe case reports of two patients presenting as symptomatic aseptic meningitis due to neuroleptospirosis. Both patients had significant neurological involvement at presentation in the absence of common clinical features of leptospirosis. These patients were initially managed as bacterial or viral meningitis and leptospirosis was suspected due to a history of exposure to contaminated water. Subsequently, they were diagnosed to have neuroleptospirosis by positive Leptospira serology and both patients gained full recovery.. Our report highlights the importance of considering leptospirosis as a differential diagnosis in patients with aseptic meningitis in endemic settings. Obtaining a detailed occupational and recreational history is helpful in diagnosing neuroleptospirosis promptly. We report the association of Leptospira borgpetersenii serovar (sv.) Tarassovi (strain bakeri) in causing aseptic meningitis, which has not been reported to the best of our knowledge.

Topics: Acyclovir; Adult; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antiviral Agents; Ceftriaxone; Dexamethasone; Diagnosis, Differential; Drinking Water; Humans; Leptospira; Leptospirosis; Male; Meningitis, Aseptic; Serogroup; Sri Lanka; Treatment Outcome

Leptospirosis is an acute generalized infectious disease, caused by spirochaetes, Leptospira interrogans. The severity of the disease ranges from an asymptomatic subclinical course to a fatal outcome. The three cases presented here were diagnosed serologically and had thrombocytopenia and acute renal failure as complication of anicteric leptospirosis. Our first case admitted with clinical presentation of pneumonia but clinical progress and laboratory findings made us to consider leptospirosis. The other two cases presented with aseptic meningitis were diagnosed as anicteric leptospirosis by the serological test results. One of the cases had fatal outcome but could not be strictly correlated with leptospirosis.

Topics: Acute Kidney Injury; Acyclovir; Adult; Aged; Agglutination Tests; Ampicillin; Anti-Bacterial Agents; Antibodies, Bacterial; Ceftriaxone; Clarithromycin; Doxycycline; Drug Therapy, Combination; Enoxaparin; Fatal Outcome; Female; Humans; Leptospira interrogans; Leptospirosis; Male; Middle Aged; Thrombocytopenia; Turkey