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Published on: December 19, 2025
348
Leptospirosis presenting as honeymoon fever
B de Sainte Marie1, M Delord1, G Dubourg2
1IHU Méditerranée Infection, Pôle des Maladies Infectieuses et Tropicales Clinique et Biologique, Service de Maladies Infectieuses et Tropicales, CHU Nord, Assistance Publique - Hôpitaux de Marseille, Chemin de Bourrelys, 13015 Marseille, France.
Summary
Leptospirosis is a significant travel-associated infection in tropical regions. Early empirical treatment with doxycycline and cephalosporin, alongside PCR and serology for diagnosis, is crucial for travelers.
Area of Science:
- Infectious Diseases
- Travel Medicine
- Microbiology
Background:
- Western travelers to tropical regions face risks of travel-associated infections.
- Malaria prophylaxis is common, but other infections require consideration.
- Adventure travel increases exposure risks.
Observation:
- A couple returning from Colombia presented with non-malarial febrile illness.
- Initial tests for malaria and arboviruses were negative.
- Leptospirosis was diagnosed via PCR in both patients, with positive IgM in one.
Findings:
- Leptospirosis should be considered in febrile travelers after malaria exclusion.
- Accurate diagnosis requires both serology and PCR (blood and urine).
- Empirical treatment with doxycycline and third-generation cephalosporins is recommended.
Implications:
- Doxycycline prophylaxis is effective against leptospirosis, rickettsial infections, and traveler's diarrhea.
- Physicians should consider leptospirosis in the differential diagnosis for febrile travelers.
- Comprehensive diagnostic approaches are vital for travel-associated infections.
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