Leptospirosis Cases Infected with Uncommon Serogroups, Puerto Rico, 2013-2015

Leptospirosis is an emerging bacterial zoonosis that is endemic but underrecognized throughout the tropics. Through prospective surveillance for acute febrile illness (AFI) among patients who presented to the emergency department of a hospital located in an urban region of Puerto Rico, four patients...

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Published inThe American journal of tropical medicine and hygiene Vol. 98; no. 1; pp. 258 - 261
Main Authors Gorbea, Hector, Garcia-Rivera, Enid J, Torres, Hilda, Lorenzi, Olga D, Rivera, Aidsa, Galloway, Renee L, Sharp, Tyler M
Format Journal Article
LanguageEnglish
Published United States Institute of Tropical Medicine 01.01.2018
The American Society of Tropical Medicine and Hygiene
Subjects
Adult
Female
Humans
Leptospira
Leptospirosis
Leptospirosis - diagnosis
Leptospirosis - epidemiology
Leptospirosis - microbiology
Leptospirosis - pathology
Male
Middle Aged
Patients
Puerto Rico - epidemiology
Young Adult
Puerto Rico
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Summary:Leptospirosis is an emerging bacterial zoonosis that is endemic but underrecognized throughout the tropics. Through prospective surveillance for acute febrile illness (AFI) among patients who presented to the emergency department of a hospital located in an urban region of Puerto Rico, four patients with laboratory-confirmed leptospirosis were identified. All patients had signs and symptoms of AFI, including fever, headache, and dehydration. Three patients had leukocytosis with thrombocytopenia and were admitted to the hospital. One hospitalized patient presented with jaundice, icteric sclera, and hematuria and developed rhabdomyolysis, whereas another patient with pulmonary edema was admitted to the intensive care unit. Microscopic agglutination titers among the four patients were highest against serogroups Icterohaemorrhagiae (serovar Mankarso), Australis (serovar Bratislava), Bataviae (serovar Bataviae), and Canicola (serovar Canicola). These case reports demonstrate that infection with these apparently uncommon serogroups can result in illness ranging from mild to life-threatening.
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Authors’ addresses: Hector Gorbea, Enid J. Garcia-Rivera, and Hilda Torres, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, Puerto Rico, E-mails: hector.gorbea@upr.edu, enid.garcia3@upr.edu, and hilda.torres1@upr.edu. Olga D. Lorenzi, Aidsa Rivera, and Tyler M. Sharp, Dengue Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico, E-mails: oal9@cdc.gov, erj2@cdc.gov, and tsharp@cdc.gov. Renee L. Galloway, Bacterial Special Pathogens Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA.
Financial support: The project was supported with Grant 5U01CK000274 from the Centers for Disease Control and Prevention and Grants 5S21MD000242 and 5S21MD000138 from the National Center for Minority Health and Health Disparities, National Institute of Health.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.17-0538