Leptospirosis is a spirochetal bacterial infection of great public health importance. It has a broad spectrum of clinical manifestations which goes from subclinical infection and self-limited anicteric febrile illness (80–90% of all cases) to icteric leptospiropirosis known as Weil's disease. This is a severe disease characterized by hemorrhage, acute renal failure and jaundice. It is uncommon for leptospirosis to present itself as a primary neurological disease. Additionally, acute pancreatitis is an unusual gastrointestinal manifestation. We report a case of leptospirosis presenting as ascending progressive leg weakness and complicating with acute pancreatitis in an adult patient treated at Hospital Universitário, Universidade Federal de Santa Catarina. The diagnosis was confirmed through ELISA-IgM antibody testing positive for leptospirosis. After antibiotic therapy and support treatment for a few weeks, total resolution of severe manifestations was achieved. Rare and unusual presentations of leptospirosis should be kept in mind in relevant epidemiological scenario.
Journal Information
Vol. 15. Issue 5.
Pages 493-497 (September - October 2011)
Vol. 15. Issue 5.
Pages 493-497 (September - October 2011)
Case report
Open Access
Leptospirosis presenting as ascending progressive leg weakness and complicating with acute pancreatitis
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Andre Pacheco Silva1,
, Luciana Bonnassis Burg2, João Felipe Schadeck Locatelli3, Joice Manes1, Morgana Crispim1
Corresponding author
andreps_garopaba@yahoo.com.br
Correspondence to: Hospital Universitário Universidade Federal de Santa Catarina Departamento de Clínica Médica Rua Profª Maria Flora Pausewang, Sn Trindade 88040-900 - Florianopolis, SC, Brazil.
Correspondence to: Hospital Universitário Universidade Federal de Santa Catarina Departamento de Clínica Médica Rua Profª Maria Flora Pausewang, Sn Trindade 88040-900 - Florianopolis, SC, Brazil.
1 Resident Physicians in Internal Medicine, Hospital Universitário, Universidade Federal de Santa Catarina (UFSC), SC, Brazil
2 Specialist in Clinical Gastroenterology; Postgraduate in Hepatology focused on Hepatic Transplantation; Emergency Physician at Hospital Universitário, UFSC; Preceptor Physician for the Internal Medicine Residency Program at Hospital Universitário, UFSC; Member of the Câmara Técnica de Transplante de Fígado do Estado de Santa Catarina; Physician, Imperial Hospital de Caridade, Florianópolis, SC, Brazil
3 Medical Student, UFSC, SC, Brazil
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Article information
Abstract
Keywords:
leptospirosis
pancreatitis
neurologic manifestations
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References
[2.]
P.N. Levett.
Leptospirosis.
Clin Microbiol Rev, 14 (2001), pp. 296-326
[3.]
R.B. Reis, G.S. Ribeiro, R.D. Felzemburgh, et al.
Impact of environment and social gradient on Leptospira infection in urban slums.
PLoS Negl Trop Dis, 2 (2008), pp. 228
[4.]
P. Ramakrishna, V.V. Sai Naresh, B. Chakrapani, et al.
Indian J Nephrol, 18 (2008), pp. 130-131
[5.]
C. Mumford, N. Dudley, H. Terry.
Leptospirosis presenting as a flaccid paraplegia.
Postgrad Med J, 66 (1990), pp. 218-220
[6.]
J.N. Panicker, R. Mammachan, R.V. Jayakumar.
Primary neuroleptospirosis.
Postgrad Med J, 77 (2001), pp. 589-590
[7.]
A.M. Bal, R.S. Bharadwaj, N. Gita, et al.
Guillain-Barré syndrome in a pediatric patient following infection due to Leptospira.
Jpn J Infect Dis, 56 (2003), pp. 29-31
[8.]
A.G. Morgan, F. Cawich.
Ascending polyneuropathy in leptospirosis- a case study.
Ann Trop Med Parasitol, 74 (1980), pp. 567-568
[9.]
G. Casella, L.F. Scatena.
Mild pancreatitis in leptospirosis infection.
Am J Gastroenterol, 95 (2000), pp. 1843-1844
[10.]
C.N. Edwards, G.D. Nicholson, T.A. Hassel, et al.
Leptospirosis in Barbados.
W. Indian Med J, 39 (1990), pp. 27-34
[11.]
C.N. Edwards, C.O.R. Evarard.
Hyperamylasemia and pancreatitis in leptospirosis.
Am J Gastroenterol, 86 (1991), pp. 1665-1668
[12.]
D. Mana, J. Karantzias, D. Bagilet, et al.
Leptospiroses e hiperamilasemia.
Med Intens, 19 (2000), pp. 16-18
[13.]
S. Monno, Y. Mizushima.
Leptospirosis with acute acalculous cholecystitis and pancreatitis.
J Clin Gastroenterol, 16 (1993), pp. 52-54
[14.]
M.M. O’Brien, J.M. Vincent, D.A. Person, et al.
Leptospirosis and pancreatitis: a report of ten cases.
Pediat infect Dis J, 17 (1998), pp. 436-438
[15.]
E. Stolze, J.D.G. Schaads, P.H. Bool.
Weil's Disease associated with pancreatic necrosis. Report on a case.
Trop Geogr Med, 11 (1959), pp. 93-95
[16.]
J.M. Vincent, M.M. Obrien, D.A. Person, et al.
Leptospirosis and pancreatitis.
Pediat Infect Dis J, 18 (1999), pp. 400
[17.]
E.F. Daher, D.M. Brunetta, G.B. Silva Junior, et al.
Pancreatic involvement in fatal human leptospirosis: clinical and histopathological features.
Rev Inst Med Trop S Paulo, 45 (2003), pp. 307-313
[18.]
H. Leblebicioglu, I. Sencan, M. Sunbul, et al.
Weil's disease: Report of 12 cases.
Scand J Infect Dis, 28 (1996), pp. 637-639
[19.]
E. Kaya, A. Dervisoglu, C. Eroglu, et al.
Acute pancreatitis caused by leptospirosis: Report of two cases.
World J Gastroenterol, 11 (2005), pp. 4447-4449
[20.]
N.D. Pai, P. Adhikari.
Painless pancreatitis: a rare manifestation of leptospirosis.
J Assoc Physic Ind, 50 (2002), pp. 1318-1319
[21.]
K.K. Kishor, P.V. Rao, K.R. Bhat, et al.
Pancreatitis in Weil's disease.
Trop Doct, 32 (2002), pp. 230-231
[22.]
R.H. Rosa, A. Dias, B. Pascoa, et al.
Leptospirose e pancreatite aguda.
J Port Gastrenterol, 11 (2004), pp. 210-212
[23.]
A.M. Bal.
Unusual clinical manifestations of leptospirosis.
J Postgrad Med, 51 (2005), pp. 179-183
[24.]
Ropper AH, Wijdicks EFM, Truax BT. Chapter 6. In: Guillain- Barré syndrome, FA Davis, Philadelphia 1991. p.57.
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