Leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis: Case report and systematic review.

Autor: Panigrahi MK; Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India., Bal SK; Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India., Tripathy TP; Department of Radiodiagnosis & Imaging, All India Institute of Medical Sciences, Bhubaneswar, India., Moorthy A; Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India., Mohanty SK; Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India., Mahapatra A; Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, India., Bhuniya S; Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India.
Jazyk: angličtina
Zdroj: Journal of infection in developing countries [J Infect Dev Ctries] 2024 Aug 31; Vol. 18 (8), pp. 1301-1307. Date of Electronic Publication: 2024 Aug 31.
DOI: 10.3855/jidc.18546
Abstrakt: Introduction: Leptospirosis and melioidosis are common in tropical and temperate climates and can be acquired by exposure to contaminated water and soil. However, concomitant leptospirosis and melioidosis infection is rarely described in the literature. We report a case of leptospirosis-melioidosis coinfection and systematically review the literature.
Case Presentation: A 42-year-old male presented with fever associated with chills and rigor, dull aching pain in the right thigh, myalgia, progressive breathlessness, and dry cough for 10 days. At presentation, he was tachypneic and had tachycardia, and oxygen saturation was 46% in room air. Chest radiography and computed tomography scan showed interstitial involvement. Magnetic resonance imaging for thigh pain revealed right femur osteomyelitis. Leptospira serology was positive, and blood culture grew Burkholderia pseudomallei, confirming the diagnosis of melioidosis. Thus, a diagnosis of presumptive leptospirosis based on modified Faine's criteria and systemic melioidosis was made. He received doxycycline and intravenous meropenem and improved.
Results: We performed a systematic review to understand the spectrum of leptospirosis-melioidosis coinfection. We identified only nine cases of coinfection described in literature. Only one patient had septic arthritis, and our case is the only one presenting with osteomyelitis. Serology diagnosed leptospirosis, whereas melioidosis was confirmed by blood culture in most patients. The majority of coinfected patients developed some complications, and six died.
Conclusions: Leptospirosis-melioidosis coinfection is rarely reported in the literature. Physicians should maintain a high index suspicion of leptospirosis-melioidosis coinfection in patients presenting with acute febrile illness following exposure to soil or freshwater, particularly in tropical and endemic regions.
Competing Interests: No Conflict of Interest is declared
(Copyright (c) 2024 Manoj Kumar Panigrahi, Shakti Kumar Bal, Tara Prasad Tripathy, Akshaya Moorthy, Swadesh Kumar Mohanty, Ashoka Mahapatra, Sourin Bhuniya.)
Databáze: MEDLINE
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