1/21. Acute acalculous cholecystitis in leptospirosis.The authors present three patients with acalculous cholecystitis seen at a tertiary care center in Bangkok. The first patient was explored surgically because peritonitis was suspected. The two other patients were treated conservatively with antibiotics and supportive care, and they recovered fully. The diagnosis of leptospirosis was confirmed by increasing antibody titers in three patients and by blood culture in one patient. leptospira were not detected in the surgical specimen. leptospirosis is a systemic disease that can present with a multitude of symptoms and signs including right upper quadrant pain mimicking cholecystitis. A high level of awareness and appropriate laboratory studies should allow early diagnosis and may prevent unnecessary surgical intervention.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/21. Tubulointerstitial renal failure in childhood leptospirosis.We report three children with tubulointerstitial renal failure following leptospirosis. All had acute nonoliguric renal failure with mild hypocalemia and mild metabolic acidosis. Maximum blood urea nitrogen (BUN) and creatinine were 217 and 7.1 mg/dl, respectively, on the 6th day of disease, and no patient required dialysis. They presented with acute febrile illness and dehydration, and required intravenous fluid supplements. myalgia, vomiting, and bleeding were found in two children. abdominal pain, arthralgia, diarrhea, and conjunctival suffusion were found in one child. Only one child, who had an underlying disease of beta-thalassemia/Hb E, had jaundice, hepatosplenomegaly, anemia, and thrombocytopenia. Penicillin treatment was given in one case. All recovered, with normal renal function. The leptospirosis complement fixation test was used to confirm diagnosis. L. batavia was considered the etiologic agent in two of the children.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
3/21. Pulmonary haemorrhage as a predominant cause of death in leptospirosis in seychelles.We examined the cause of death during a 12-month period (1995/96) in all consecutive patients admitted to hospital with leptospiral infection in seychelles (indian ocean), where the disease is endemic. leptospirosis was diagnosed by use of the microscopic agglutination test and a specific polymerase chain reaction assay on serum samples. Seventy-five cases were diagnosed and 6 patients died, a case fatality of 8%. All 6 patients died within 9 days of onset of symptoms and within 2 days of admission for 5 of them (5 days for the 6th). On autopsy, diffuse bilateral pulmonary haemorrhage (PH) was found in all fatalities. Renal, cardiac, digestive and cerebral haemorrhages were also found in 5, 3, 3 and 1 case(s), respectively. Incidentally, haemoptysis and lung infiltrate on chest radiographs, which suggest PH, were found in 8 of the 69 non-fatal cases. dengue and hantavirus infections were ruled out. In conclusion, PH appeared to be a main cause of death in leptospirosis in this population, although haemorrhage in other organs may also have contributed to fatal outcomes. This cause of death contrasts with the findings generally reported in endemic settings.- - - - - - - - - - ranking = 0.49595965636851keywords = chest (Clic here for more details about this article) |
4/21. Massive ocular hemorrhage resulting in blindness in a patient with the sickle cell trait who developed leptospirosis. Case report.This case report describes the findings of a 18 year-old black male from Bahia, a Northeastern state in brazil, with the sickle cell trait, who developed bilateral hyphema and vitreous hemorrhage with blindness in the course of leptospirosis. The patient started to complain of blurred vision four days after the start of fever and muscular pain and approximately twelve hours after the introduction of penicillin. The severity of the leptospirosis in conjunction with sickle cell trait was considered to be the most likely explanation for this ocular complication.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
5/21. The first case of leptospirosis in the Zadar area.In September 1999, a 56-year-old butcher was admitted to the General Hospital in Zadar because of fever, headache, severe pain in the calf muscles and thighs, conjunctivitis, rash, hepatomegaly and jaundice. The initial diagnosis was septic shock, and the patient was admitted to the internal medicine ward. Microscopic agglutination test showed a fourfold rise of antibodies to leptospira sejroe in the three serum samples. These serologic findings and laboratory findings of leukocytosis, thrombocytopenia, increased serum aminotransferases, blood urea nitrogen and creatinine, proteinuria and leukocyturia indicated that leptospira sejroe was the etiologic agent of the disease in the patient presented.- - - - - - - - - - ranking = 6.179548156956keywords = headache, pain (Clic here for more details about this article) |
6/21. leptospirosis mimicking acute cholecystitis among athletes participating in a triathlon.leptospirosis, a disease acquired by exposure to contaminated water, is characterized by fever accompanied by various symptoms, including abdominal pain. An acute febrile illness occurred in athletes who participated in an illinois triathlon in which the swimming event took place in a freshwater lake. Of 876 athletes, 120 sought medical care and 22 were hospitalized. Two of the athletes had their gallbladders removed because of abdominal pain and clinical suspicion of acute cholecystitis. We applied an immunohistochemical test for leptospirosis to these gallbladders and demonstrated bacterial antigens staining (granular and filamentous patterns) around blood vessels of the serosa and muscle layer. Rare intact bacteria were seen in 1 case. These results show that leptospirosis can mimic the clinical symptoms of acute cholecystitis. If a cholecystectomy is performed in febrile patients with suspicious environmental or animal exposure, pathologic studies for leptospirosis on formalin-fixed, paraffin-embedded tissues may be of great value.- - - - - - - - - - ranking = 17.686932684783keywords = abdominal pain, pain (Clic here for more details about this article) |
7/21. leptospirosis: report of one case.An 8-year-old male aborigine was referred to our hospital with a presumptive diagnosis of Kawasaki disease. The major symptom presented was a persistent fever for six days. Several other symptoms were drowsiness, headache, nausea, vomiting, abdominal pain, diarrhea, nuchal rigidity, lymphadenopathy, subconjunctival hemorrhage, and muscle aching of the calf. During hospitalization, cerebrospinal fluid studies showed pleocytosis. Abdominal sonograms revealed hepatosplenomegaly, moderate ascites and gallbladder wall thickening. These data were suggestive of leptospirosis. The microscopic agglutination test of leptospiral antibodies further confirmed the diagnosis. After treatment with intravenous aqueous penicillin and gentamicin, the clinical course improved significantly.- - - - - - - - - - ranking = 14.023014499348keywords = abdominal pain, headache, pain (Clic here for more details about this article) |
8/21. Haemorrhagic pneumonitis: A rare presentation of leptospirosis.leptospirosis is an uncommon zoonosis. As a systemic disease, it presents itself by multisystem involvement. Pulmonary involvement with leptospirosis often is manifested by respiratory symptoms; but pneumonia commonly is not a prominent clinical manifestation of the illness. We report a case of leptospiral pneumonia in which pulmonary manifestations were primary clinical features of the illness. The prompt resolution of chest x-ray on institution of treatment is noteworthy.- - - - - - - - - - ranking = 0.49595965636851keywords = chest (Clic here for more details about this article) |
9/21. Painless pancreatitis: a rare manifestation of leptospirosis.A rare case of painless pancreatitis caused by leptospira is reported. The patient presented clinically with features of paralytic ileus and renal failure. hyperamylasemia was persistent inspite of recovery of renal function. The patient recovered on treatment with penicillin and serum amylase returned to normal in three months.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
10/21. Report of three children with leptospirosis in rural area of the east of turkey.leptospirosis is a systemic infection usually producing fever with hepatorenal involvement, meningoencephalitis, and hemorrhage. In this article, we present three children between 10 and 13 years of age with leptospirosis. The purpose of this paper is to emphasize that leptospirosis is a problem in our country with farmers/cattle and that leptospirosis should be considered in certain ill children. The main symptoms were headache, fever, fatigue, abdominal pain and unconsciousness. Two patients had hepatic and renal involvement. The other had hepatic, pulmonary and probably pericardial involvement. In all children spirochetes were demonstrated in blood and urine smears by dark-field microscopy and they were also isolated from urine and blood cultures by using Flecher medium. All patients were treated with penicillin; however, one subsequently required additional antibiotics due to klebsiella pneumoniae septicemia. While one patient was discharged in a good health, the others were taken to their home by parents without completing treatment. In conclusion, we would like to emphasize that leptospirosis is still a public health problem in our region (Eastern turkey) in where the majority of population are farmers and raise domestic animals such as cattle in rural areas. Additionally, leptospirosis should be considered in children admitted with headache, unconsciousness, fever and abdominal pain.- - - - - - - - - - ranking = 28.046028998695keywords = abdominal pain, headache, pain (Clic here for more details about this article) |
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