1/1. leptospirosis presenting with mania and psychosis: four consecutive cases seen in a military hospital in turkey.OBJECTIVE: To present the clinical features and the treatment alternatives of manic and psychotic symptoms in patients with leptospirosis. methods: Clinical observation and diagnosis of four cases with leptospirosis presenting with psychiatric symptoms. RESULTS: leptospirosis diagnoses were established by recovery of the organism from culture, macroagglutination tests, and dark field microscopy in all cases. leptospira ELISA-Ig M was also positive in all cases. Microagglutination tests were positive in case 1 and case 2. All of the cases were also screened for other possible medical, infectious, and neurological disorders that could account for their clinical symptoms. patients were treated with a combination of antibiotics, antipsychotics and mood stabilizers. CONCLUSIONS: The presence of manic and psychotic symptoms with fever and high transaminase and/or CPK levels in high risk occupational groups during rainy periods should alert the physician to the possibility of leptospirosis. The psychiatric symptoms are sensitive to anti-psychotics and mood stabilizers but not to antimicrobial treatment, suggesting that the psychiatric picture may not be related to direct invasion of the central nervous system by the infectious agent.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |