LEPTOSPIROSIS IN A GERIATRIC PATIENT WHO FREQUENTLY WALKS BAREFOOT ON THE BEACH.

Leptospirosis, a worldwide zoonosis manifesting itself in various types, is difficult to diagnose because of non-specific symptoms. A ninety-two year-old geriatric male patient was admitted to GATA Haydarpaşa Training Hospital Emergency Department with complaints of high fever, sweating, fatigue, headache, muscle aches, nausea, vomiting and the inability to walk that con-tinued for two days. In his anamnesis, he had been on vacation to Antalya, which is a coastal province on the southern coast of Turkey. Whilst on holiday, one of his activities was to walk on the beach for several hours barefoot. His complaints started 3 days on his return to Istanbul. Blood samples were sent to spirochete laboratory of Etlik Central Veterinary Control and Research Institute. He was discharged from the Institute on 100 mg of doxycycline and 500 mg of ciprofloxacin (bid, per oral). One week later, Institute reported that the antibodies for leptospi-ra were positive. A microagglutination test confirmed the serovar Leptospira icterohaemorrha-giae, with the titers of 1:400. After two weeks of treatment, his physical examination and labo-ratory tests were found to be normal. In conclusion, a careful assessment of risk factors in the case history of the patient with non-spesific symptoms such as high fever, frontal headache, myal-gia and conjunctival hyperemia will assist the diagnosis of leptospirosis. Laboratory results such as neutrophilia, thrombocytopenia, high degree of creatine kinase also play an important role in the diagnosis of the disease. Early treatment should be started as soon as possible to prevent fur-ther aggravation of the disease. [ABSTRACT FROM AUTHOR]