Nadir Bir Leptospirozis Kliniği: Karaciğer Enzimlerinde Uzun Süreli Yükseklik

Year 2023, Volume: 25 Issue: 3, 290 - 292, 30.12.2023

Yasemin Çakır , Özlem Gökçe , Bekir Tunca

https://doi.org/10.18678/dtfd.1320618

Abstract

Leptospiroz, birçok tropikal ve subtropikal bölgede endemik olan bakteriyel bir zoonozdur. Hastalık insanlara enfekte hayvanların idrarıyla veya idrarıyla kontamine olmuş bir ortamla temas yoluyla bulaşmaktadır. Leptospirozun klinik belirtileri subklinik enfeksiyondan çoklu organ fonksiyon bozukluğu ile seyreden ağır hastalık tablosuna kadar değişkenlik göstermektedir. Bu vaka raporunun amacı, endemik olmayan bir bölgede, detaylı anamnez ile tanı konulan ve karaciğer fonksiyon testlerinde uzun süreli yükselme ile seyreden bir leptospirosis olgusunu sunmaktır. 28 yaşında erkek hasta, halsizlik, ateş ve kusma şikayetleriyle başvurdu. Hiperbilirubinemi, karaciğer enzim yüksekliği ve böbrek yetmezliği olan hastanın ayrıntılı anamnez sonucu kırsal bölgede kirli su ile teması olduğu öğrenildi ve hasta leptospiroz ön tanısı ile takip edildi. Leptospirosis farklı klinik bulgularla ortaya çıkabildiği ve birçok hastalıkla da karışabildiği için risk faktörlerinin dikkatle sorgulanması gerekir.

Keywords

Akut böbrek yetmezliği, Leptospirozis, Karaciğer fonksiyon testleri

A Rare Manifestation of Leptospirosis: Long-Term Elevation in Liver Enzymes

Abstract

Leptospirosis is a bacterial zoonosis that is endemic in many tropical and subtropical regions. The disease is transmitted to humans by contact with the urine or an environment contaminated with the urine of infected animals. The clinical manifestations of leptospirosis vary from subclinical infection to severe illness with multiorgan dysfunction. This case report aimed to present a leptospirosis case diagnosed with detailed anamnesis and progressed with long-term elevation in liver function tests, in a non-endemic region. A 28-year-old male patient was admitted with complaints of weakness, fever, and vomiting. As a result of the detailed anamnesis, it was learned that the patient with hyperbilirubinemia, elevated liver enzymes, and kidney failure had contact with polluted water in a rural area, and the patient was followed up with a preliminary diagnosis of leptospirosis. Leptospirosis may present with different clinical presentations and be confused with many diseases, risk factors should be carefully questioned.

Keywords

Acute kidney injury, Leptospirosis, Liver Function Tests

References

• Bharti AR, Nally JE, Rinaldi JN, Matthias MA, Diaz MM, Lovett MA, et al. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis. 2003;3(12):757-71.
• Van Dijck C, Van Esbroeck M, Rutsaert R. A 54-year-old Philippine sailor with fever and jaundice. Acta Clin Belg. 2016;71(5):319-22.
• Picardeau M. Diagnosis and epidemiology of leptospirosis. Med Mal Infect. 2013;43(1):1-9.
• Costa F, Hagan JE, Calcagno J, Kane M, Torgerson P, Martinez-Silveira MS, et al. Global morbidity and mortality of leptospirosis: A systematic review. PLoS Negl Trop Dis. 2015;9(9):e0003898.
• Arean VM. Studies on the pathogenesis of leptospirosis. II. A clinicopathologic evaluation of hepatic and renal function in experimental leptospiral infections. Lab Invest. 1962;11:273-88.
• Miyahara S, Saito M, Kanemaru T, Villanueva SY, Gloriani NG, Yoshida S. Destruction of the hepatocyte junction by intercellular invasion of Leptospira causes jaundice in a hamster model of Weil's disease. Int J Exp Pathol. 2014;95(4):271-81.
• Barocchi MA, Ko AI, Reis MG, McDonald KL, Riley LW. Rapid translocation of polarized MDCK cell monolayers by Leptospira interrogans, an invasive but nonintracellular pathogen. Infect Immun. 2002;70(12):6926-32.
• Faggion Vinholo T, Ribeiro GS, Silva NF, Cruz J, Reis MG, Ko AI, et al. Severe leptospirosis after rat bite: a case report. PLoS Negl Trop Dis. 2020;14(7):e0008257.
• Haake DA, Levett PN. Leptospirosis in humans. Curr Top Microbiol Immunol 2015;387:65-97.
• Chacko CS, Lakshmi S, Jayakumar A, Binu SL, Pant RD, Giri A, et al. A short review on leptospirosis: clinical manifestations, diagnosis, and treatment. Clin Epidemiol Global Health. 2021;11:100741.