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BMJ Case Reports 2018; doi:10.1136/bcr-2018-225281
  • Unusual presentation of more common disease/injury
  • CASE REPORT

Uncommon manifestation of leptospirosis: a diagnostic challenge

  1. Ashutosh Biswas4
  1. 1Junior Resident, Department of Medicine, All India Institute of Medical Sciences, New Delhi
  2. 2Senior Resident, Department of Medicine, All India Institute of Medical Sciences, New Delhi
  3. 3Associate Professor, Department of Medicine, All India Institute of Medical Sciences, New Delhi
  4. 4Professor, Department of Medicine, All India Institute of Medical Sciences, New Delhi
  1. Correspondence to Dr Manish Soneja, manishsoneja{at}gmail.com
  • Accepted 10 September 2018
  • Published 7 October 2018

Summary

Leptospirosis is a zoonotic disease commonly affecting the tropical countries. It may have protean clinical manifestations including hepatorenal dysfunction, myocarditis, pulmonary haemorrhage, meningitis, optic neuritis and rhabdomyolysis. Neurological manifestation of leptospirosis without the classical hepatorenal dysfunction is a rare entity. This complication of leptospirosis can present with diverse central and peripheral neurological presentations. The overlapping clinical manifestations with many common tropical pathogens often pose diagnostic dilemma and delay in definitive therapy may lead to adverse clinical consequences. We report a case of a 19-year-old man with no prior comorbidities presenting with high-grade fever and altered sensorium. He was diagnosed to be a probable case of leptospirosis, based on all available test results and by fulfilment of parameters under modified Faine’s criteria. The patient was successfully managed and discharged in stable condition.

Footnotes

  • Contributors Acquisition of data or analysis and interpretation of data: MB, NR and MS. Drafting the article or revising it critically for important intellectual content: MB, NR and MS. Final approval of the version published: MS and AB. Agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved: MS and AB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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