The farmer who didn't need a wheel barrow

Area of Science:

• Infectious Diseases
• Internal Medicine
• Medical Diagnostics

Background:

• Leptospirosis is a zoonotic infection with diverse clinical presentations.
• Non-specific signs and symptoms can mimic other serious conditions, complicating diagnosis.
• Elderly patients may present with atypical or exacerbated symptoms, posing diagnostic challenges.

Purpose of the Study:

• To illustrate the diagnostic difficulties of leptospirosis in an elderly patient.
• To emphasize the importance of a comprehensive diagnostic approach, including occupational history.
• To highlight the successful outcome following prompt antibiotic therapy.

Main Methods:

• Case report of an 85-year-old male farmer presenting with non-specific symptoms.
• Initial extensive hematologic and oncologic investigations were performed.
• Diagnosis was confirmed after thorough review of results and consideration of patient's profession.

Main Results:

• Initial work-up did not yield a definitive diagnosis.
• Patient experienced rapid deterioration with multi-organ dysfunction symptoms.
• Leptospirosis was identified, leading to appropriate treatment and full recovery.

Conclusions:

• Leptospirosis diagnosis can be delayed in elderly individuals presenting with non-specific symptoms.
• Occupational exposure history is crucial for identifying potential zoonotic infections.
• Early diagnosis and treatment of leptospirosis are essential for favorable outcomes.