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BACKGROUND: Leptospirosis or also commonly called Weil disease is an acute infectious disease that can attack humans and animals and is classified as a zoonotic disease. Leptospirosis is caused by bacteria of the genus Leptospira found in rodents. The difficulty of the diagnosis process causes the case of leptospirosis less reported and is one of the neglected infectious diseases. Patient findings are often not optimal because of underdiagnosis or misdiagnosis. AIM: This study aims to determine the presence of Leptospira serovar bacteria in blood serum of leptospirosis suspect using the microscopic agglutination test (MAT) method. METHODS: This study is a descriptive observational using accidental sampling technique. Sample collection was performed in the Antang Community Health Center, Batua Health Center, and Bangkala Health Center in Manggala District. RESULTS: This study found that there were 31 serum samples. Results of MAT examination on blood serum yielded 11 positive samples of Leptospira (37%) with serovar Hebdomadis, Djasiman, Mini, Icterohaemorrhagiae, Bangkingan, and Bataviae. CONCLUSIONS: The presence of Leptospira bacteria in blood serum of suspected individuals using the MAT method obtained 11 samples of positive blood serum. Special counseling activities are required about leptospirosis and diagnosis enforcement in the community or workers who experience symptoms or leptospirosis suspect.

Leptospirosis or also commonly called Weil disease is an acute infectious disease that can attack humans and animals and is classified as a zoonotic disease. Leptospirosis is caused by bacteria of the genus Leptospira found in rodents. This study aims to determine the presence of Leptospira bacteria serovar in blood serum suspected of leptospirosis using the Microscopic Aglutination Test (MAT) method. This type of research is descriptive observational using accidental sampling technique with a total of 31 samples. Sampling was conducted at the Antang Community Health Center, Batua Health Center and Bangkala Health Center in Manggala District for two weeks. Data analysis in this research is descriptive in which the results are presented through tables and narratives. The results of MAT examination on blood serum yielded eleven positive samples of Leptospira (37%) with serovar Hebdomadis, Djasiman, Mini, Icterohaemorrhagiae, Bangkingan and Bataviae. The presence of Leptospira bacteria in the blood serum of suspected individuals using the MAT Method obtained 11 samples of positive blood serum. Need to conduct and improve special counseling activities about leptospirosis and diagnosis enforcement in the community or workers who experience symptoms or suspected leptospirosis.

Resumen Introducción. La leptospirosis es una infección bacteriana endémica en Colombia. Su curso clínico puede ser variable y, en ocasiones, fatal. Hay pocos estudios en el país sobre los casos graves de esta enfermedad. Objetivo. Describir las características demográficas y clínicas de los pacientes con diagnóstico de leptospirosis grave hospitalizados en salas generales o atendidos en la unidad de cuidados intensivos de un hospital de cuarto nivel. Materiales y métodos. Se llevó a cabo un estudio observacional descriptivo de los pacientes adultos y niños con diagnóstico serológico de leptospirosis entre el 2010 y el 2016. Resultados. Se analizaron las historias clínicas de 87 pacientes, 74 % de los cuales correspondía a hombres y, el 84 %, a mayores de 18 años. El 35 % tenía alguna comorbilidad y la hipertensión arterial sistémica (16 %) y la diabetes mellitus (9 %) fueron las más comunes. Los síntomas más frecuentes fueron: fiebre, náuseas, astenia, mialgias, artralgias y dolor abdominal. El 34 % requirió atención en la unidad de cuidados intensivos, con una mediana de estancia de 5 días. El 61 % requirió hospitalización en sala general, con una mediana de estancia de 6 días. Todos los casos recibieron tratamiento antibiótico con ceftriaxona o doxiciclina. La tasa de letalidad fue del 1,1 % (n=1). Conclusiones. La infección por Leptospira spp. tiene el riesgo de diagnosticarse de manera tardía por su presentación clínica inespecífica, lo que implica considerar un gran número de diagnósticos diferenciales. La atención temprana de los pacientes con cuadros graves de esta enfermedad en la unidad de cuidados intensivos, puede evitar una mayor incidencia de complicaciones y disminuir la mortalidad. Abstract Introduction: Leptospirosis is an endemic bacterial infection in Colombia. Its clinical course can be variable and occasionally fatal. There are few studies in the country about severe cases of leptospirosis. Objectives: To describe the demographic and clinical characteristics of patients with a diagnosis of leptospirosis, and their management in a high complexity hospital. Materials and methods: This was a descriptive retrospective study of patients with a serologic diagnosis of leptospirosis between 2010 and 2016. Results: We analyzed 87 patients, 74% of them were men, and 84% were older than 18 years; 35% had a comorbidity, the most common being arterial hypertension (16%) and diabetes mellitus (9%). The most frequent symptoms were fever, nausea, fatigue, myalgia, arthralgia, and abdominal pain. The majority of patients required hospitalization in general wards (61%), with a median stay of six days; 34% required management in the intensive care unit, with a median stay of five days. Mortality was 1.1% (n=1). All patients received treatment with either ceftriaxone or doxycycline. Conclusions: There is a risk of leptospira infections having a late diagnosis given their unspecific clinical presentation, which generates a high number of differential diagnoses. The early management in the intensive care unit could decrease the incidence of complications and the mortality of patients with leptospirosis.

A 21-year-old man presented with the chief complaints of fever and sore throat after visiting Cambodia and Thailand. Computed tomography revealed multiple pulmonary nodules. After performing antibiotic therapy, the pulmonary nodules without bacteremia disappeared completely. Paired microscopic agglutination tests revealed seroconversion against Leptospira serogroup Autumnalis. Thus, he was diagnosed with multiple pulmonary nodules caused by leptospirosis. Leptospirosis is a common zoonosis that occurs in tropical and subtropical areas. Its various clinical features include unspecified fever and Weil's disease. Although diffuse alveolar hemorrhaging is known to occur in severe leptospirosis, multiple pulmonary nodules resembling septic emboli or vasculitis are a rare complication.

Leptospirosis is a zoonotic disease of worldwide distribution caused by infection with Leptospira genus bacteria, a pathogenic spirochaete. We present the case of a 29-year-old man admitted to our hospital with fever and multiorgan failure. He provided poor information about his symptoms. No recent travel or occupational history was reported and his clinical presentation did not suggest any infectious foci. His relatives later disclosed that he had been homeless for 3 weeks in the context of behavioural changes, obtaining foodstuff from waste containers and water from rain puddles. In the setting of this epidemiology, his presentation of fever, jaundice, acute renal injury and thrombocytopaenia suggested leptospirosis. Prompt empirical antimicrobial coverage was started, alongside organ support therapy. The diagnosis was later confirmed through microscopical and molecular methods. The patient made a full recovery. Leptospirosis should be considered early in the diagnostic work-up of any patient with acute febrile illness with multiorgan system involvement, with the identification of risk factors being essential to treat early in development of the disease.

Leptospirosis remains the most important zoonosis in the world and is caused by the bacterium of the genus Leptospira. Clinical manifestations vary from oligosymptomatic infections to the severe, ictero-hemorrhagic form, called Weil’s syndrome, which include acute kidney injury (AKI). After reaching the bloodstream, the Leptospira can reach all organs, preferentially affecting the liver, kidneys, heart, and skeletal muscle, causing a vasculitis with endothelial damage and inflammatory infiltrate. The pathogenic mechanisms of leptospirosis can be divided into direct effects caused by Leptospira and the effects of the host immune response. Leptospira isolated from the kidneys of chronically infected animals show an increased amount of lipopolysaccharides (LPS), suggesting that LPS expression facilitates the permanence of the bacteria in the renal tissue. The clinical picture in the early phase is often nonspecific, with fever, headache, anorexia, diarrhea, nausea, vomiting, and malaise, as well as myalgia, more pronounced in the calf region, constituting the most common signs and symptoms. Given this presentation, which comprises approximately 85–90% of cases, the disease is often underdiagnosed and misdiagnosed as viral infections, such as dengue. The two main mechanisms that have been associated with kidney injury by Leptospira are direct nephrotoxic action of the microorganism and toxin effect with immune response induction and indirect effects such as dehydration, rhabdomyolysis, and hypoxia due to hemodynamic changes.

Leptospirosisis a zoonosis caused by spirochaetes from the species Leptospira. The more severe form of leptospirosis, known as Weil’s disease, is characterised by the triad of jaundice, renal impairment and haemorrhages. Pulmonary involvement occurs in 20%–70% of the patients, with severity ranging from non-productive cough to respiratory failure mainly due to pulmonary haemorrhage. Recognition of Weil’s disease in patients presenting with pulmonary symptoms can be difficult. This case illustrates a classic case of pulmonary haemorrhagic involvement in Weil’s disease.