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Leptospirosis in Malaysia: a common cause of short-term fever

Brown GW, Lee CK, Huxsoll DL, Ng TS, Lim KJ, Wan HS, et al.

Southeast Asian J. Trop. Med. Public Health, 1976 Sep;7(3):380-3.

A study of 1,437 unselected febrile patients in rural Malaysia yielded a diagnosis of leptospirosis in 86 (6.0%). The clinical syndrome was mild to moderate in all cases, jaundice was observed in only 2 (2.3%) and no deaths were documented. The diagnosis was not clinically obvious in most cases, and it is apparent that many infections must be going unnoticed at present.

Matched MeSH terms: Leptospirosis/complications*

Leptospirosis complicating with acute large bowel gangrene: a case report

Zamri Z, Shaker AH, Razman J

Clin Ter, 2012;163(5):399-400.

PMID: 23099969

Leptospirosis is a zoonosis with worldwide distribution. It is often referred to as swineherd's disease, swamp fever or mud fever. In recent years there is increase incidence in leptospirosis in human. The incidence varies from sporadic in temperate zones to endemic in the tropical countries. Leptospirosis generally present with features of bacterial infection in acute phase following with multi organs complications. Acute bowel ischaemia with perforation following leptospirosis is a rare presentation . To the best of our knowledge, this is the first case report of such condition. The surgical management of this rare incidence will be discussed.

Matched MeSH terms: Leptospirosis/complications*

Fulltext 16 cases of acute renal failure due to leptospirosis

Tan DSK, Suleiman AB, Jeyaindran S

Med J Malaysia, 1986 Jun;41(2):152-5.

PMID: 3821611

A study was carried out on 16 cases of leptospirosis with acute renal failure (ARF) detected in adult patients admitted into the Medical and Nephrology wards of the General Hospital, Kuala Lumpur, over a four-year period from 1980 to 1983. Most of the cases were male, Malays and older adults. The predominant infecting serovars were L. celledoni (of the serogroup L. javanica and L. pomona (of the L. pomona serogroup]. All the cases survived, including those who required peritoneal dialysis. The sensitised erythrocyte lysis (SEL) antibody prevalence rate of the chronic renal failure cases (10.4%) was found to be similar to that of the healthy population in West Malaysia (12. 7%), confirming the observation by other workers that leptospirosis is not an important cause of chronic renal failure.

Matched MeSH terms: Leptospirosis/complications*

Leptospirosis in pregnancy: A lesson in subtlety

Rahimi R, Omar E, Tuan Soh TS, Mohd Nawi SFA, Md Noor S

Malays J Pathol, 2018 Aug;40(2):169-173.

PMID: 30173235 MyJurnal

INTRODUCTION: Leptospirosis is a zoonotic disease caused by spirochaete of the genus Leptospira. Human infection occurs after exposure to water or soil contaminated by urine from an infected animal. Most patients manifest as self-limited systemic illness. However 10% of patients manifest as severe disease associated with high fatality. The disease affects mostly men, cases involving pregnant women are uncommon. We presented a case of leptospirosis in a pregnant woman leading to mortality of both mother and foetus.

CASE REPORT: A 28-year-old woman at 18 weeks of gestation, had shortness of breath and collapsed. She was brought unconscious to the emergency department and died shortly after arrival. A week prior to this, she had presented to the same hospital with pain on both thighs. Examination of the patient and ultrasound of the foetus revealed normal findings. Post mortem examination revealed hepatosplenomegaly and congested lungs; no jaundice, meningeal inflammation or cardiac abnormalities was evident. Histopathology examination of the lungs revealed pulmonary haemorrhages and oedema. Multiple infarcts were seen in the spleen and the kidneys showed foci of acute tubular necrosis. Laboratory investigations revealed Leptospira IgM antibody and PCR for leptospira were positive. This case illustrates the subtleness of clinical presentation of leptospirosis. The diagnosis was obscure even at post-mortem and was only suspected following histopathological examination, leading to further investigations.

CONCLUSION: Leptospirosis may have a subtle presentation and a high index of suspicion for this infection is required for early identification of the disease.

Matched MeSH terms: Leptospirosis/complications*

Fulltext Leptospirosis: pulmonary hemorrhage in a returned traveller

Leung V, Luong ML, Libman M

CMAJ, 2011 Apr 19;183(7):E423-7.

PMID: 21262944 DOI: 10.1503/cmaj.092203

Matched MeSH terms: Leptospirosis/complications*

Fulltext Fatal co-infection--melioidosis and leptospirosis

Hin HS, Ramalingam R, Chunn KY, Ahmad N, Ab Rahman J, Mohamed MS

Am J Trop Med Hyg, 2012 Oct;87(4):737-40.

PMID: 22826499 DOI: 10.4269/ajtmh.2012.12-0165

Co-infection of melioidosis and leptospirosis is uncommon. We report here four such cases, confirmed by blood culture for melioidosis and blood polymerase-chain reaction for leptospirosis, which occurred among rescuers involved in a search and rescue operation for a young man who was suspected to have drowned in Lubuk Yu, a recreational forest in Pahang, Malaysia. Despite treatment, three of the patients died from the co-infection.

Matched MeSH terms: Leptospirosis/complications*

Leptospirosis in a caver returned from Sarawak, Malaysia

Mortimer RB

Wilderness Environ Med, 2005;16(3):129-31.

PMID: 16209467

This article describes a case of leptospirosis in a man who returned from caving in Sarawak, Malaysia, and includes a discussion of epidemiology, pathophysiology, diagnosis, prevention, and treatment. The patient presented with symptoms of leptospirosis, which was confirmed by microhemagglutination titers. He became infected despite taking doxycycline daily for malaria prophylaxis. Leptospirosis is an important consideration in any returned traveler with fever. The spirochete spreads from animals to humans via water. Caving in tropical endemic zones may increase exposure risk due to the combination of multiple skin abrasions with immersions. Water in caves may increase infection risk because of increased water pH. Standard prophylaxis may be inadequate in cases of high-risk exposures.

Matched MeSH terms: Leptospirosis/complications

The patient who had a picnic at a waterfall and presented with haemoptysis and renal failure

Thiruventhiran T, Tan SY

Nephrol Dial Transplant, 2000 May;15(5):727-8.

PMID: 10809822

Matched MeSH terms: Leptospirosis/complications*

Fulltext A case of severe leptospirosis with pancytopaenia

Bee PC, Chow SK, Tan LH

Med J Malaysia, 2003 Dec;58(5):777-9.

PMID: 15190670

Pancytopaenia is a rare clinical presentation of severe leptospirosis. We would like to report a case of severe leptospirosis that progressed to pancytopaenia despite initial penicillin therapy. The patient needed a second course of antibiotic with doxycycline to improve his persistent symptoms and cytopaenia. Persistent pancytopaenia in severe leptospirosis and its management were reviewed.

Matched MeSH terms: Leptospirosis/complications*

Fulltext Mortality of leptospirosis associated acute kidney injury (LAKI) & predictors for its development in adults: A systematic review

Al Hariri YK, Sulaiman SAS, Khan AH, Adnan AS, Al Ebrahem SQ

J Infect Public Health, 2019 07 04;12(6):751-759.

PMID: 31281106 DOI: 10.1016/j.jiph.2019.06.014

Leptospirosis is the most widely spread zoonosis and Leptospirosis Associated Acute Kidney Injury (LAKI) is common and fatal if not properly and swiftly treated. The aim of this review is to evaluate the mortality of LAKI and to identify the risk factors for its development. An electronic search was performed to identify the studies included LAKI patients series. Only studies which investigated mortality or risk factors for LAKI development in adults were included. Twenty-three studies with 24 patients series were included in the final analysis and included 1698 patients. The median series mortality was 10.05% (range 0-33.3%) with a total of 223 death. Only four studies identified the independent risk factors for LAKI development which were oliguria, jaundice, arrhythmia, crackles, elevated direct bilirubin level, elevated activated prothrombin time, hyperbilirubinemia and leukocytosis. Although the mortality of LAKI is high, its predictors are not studied enough in literature.

Matched MeSH terms: Leptospirosis/complications*

Fatal Leptospirosis and Escherichia coli co-infection in a post-partum woman

Tan TL, Lee LY, Lim WC

Med J Malaysia, 2018 12;73(6):427-429.

PMID: 30647223

The occurrence of Leptospirosis and Escherichia coli coinfection in the post-partum period is a novel case. This report illustrated a previously well woman from a suburban area presented with acute neurological deterioration following a two days history of fever during her puerperal period. Early interventions with fluids, broad spectrum antibiotics and intensive supportive care were given. Despite that, she deteriorated rapidly and developed pulmonary hemorrhage, disseminated intravascular coagulopathy, and multi-organ failure. She succumbed within 12 hours of admission. The knowledge about such fatal co-infections should be disseminated to medical practitioners encountering Leptospirosis infection and general public.

Matched MeSH terms: Leptospirosis/complications*

Hyperosmolar non-ketotic diabetic coma following leptospirosis--a case report

Chan YF

Med J Malaya, 1972 Mar;26(3):211-4.

PMID: 5031019

Matched MeSH terms: Leptospirosis/complications*

Acute renal failure after a holiday in the tropics

Guron G, Holmdahl J, Dotevall L

Clin. Nephrol., 2006 Dec;66(6):468-71.

PMID: 17176921 DOI: 10.5414/cnp66468

A 20-year-old, previously healthy woman, presented with high fever, headache and myalgia 3 days after her return from a holiday in Southeast Asia. Laboratory data on admission demonstrated a pronounced increase in plasma creatinine, marked thrombocytopenia and moderately elevated liver aminotransferases. After having ruled out malaria, dengue fever was primarily suspected and supportive intravenous fluid therapy was initiated. Still, 1 day after admission, platelet counts dropped even further and she became anuric although she did not appear hypovolemic. On day 2 after admission, urine production commenced spontaneously and the patient slowly recovered. All laboratory test results had returned to normal approximately 2 months later. Serological analysis for dengue fever was negative. It turned out that the patient had been trekking in the jungle while in Thailand and we, therefore, analyzed serology for Leptospira spirochetes which was clearly positive. The patient was diagnosed with leptospirosis which is a serious condition associated with a high mortality when complicated by acute renal failure. Differential diagnoses in patients with acute renal failure and tropical infections are reviewed. The importance of early recognition of leptospirosis, and prompt treatment with antibiotics in suspected cases, is emphasized.

Matched MeSH terms: Leptospirosis/complications*

Update: Outbreak of acute febrile illness among athletes participating in Eco-Challenge-Sabah 2000--Borneo, Malaysia, 2000

Stone SC, McNutt E

Ann Emerg Med, 2001 Jul;38(1):83-4.

PMID: 11423818

Matched MeSH terms: Leptospirosis/complications*

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