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Updated: Jul 19, 2026
Immuno-fluorescence Assay of Leptospiral Surface-exposed Proteins
Published on: July 1, 2011
The importance of using a right test method in diagnosing leptospirosis
N E Ilham1, N S M Joseph1, N Bahtiar Affendy1
1Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, UPM, 43400 Serdang, Selangor, Malaysia.
Abstract:
Leptospirosis is a common febrile illness in Malaysia. The disease is caused by pathogenic bacteria called leptospires that are transmitted directly or indirectly from animals to humans via contaminated water or soil. It is a potentially serious but treatable disease. Its symptoms may mimic those of other unrelated febrile illnesses such as dengue, influenza, meningitis, hepatitis or viral haemorrhagic fevers. The spectrum of the disease is extremely wide, ranging from subclinical infection to a severe syndrome of multiorgan infection with high mortality. The diagnosis requires high suspicion with history of exposure to water or environment possibly contaminated with infected animal urine. This is a case of a 13 year-oldgirl with no known medical illness, and a history of exposure to outdoor activities. However, paired sera for leptospirosis serology was not diagnostic. She then developed septic shock on day 14 of illness. But due to high suspicion of leptospirosis, antibiotic therapy was upgraded to ceftriaxone and samples were sent for further testing which revealed that leptospires were detected in the urine, using molecular technique. She improved after treated as leptospirosis.
Insights
Leptospirosis, a serious bacterial illness, can be challenging to diagnose due to its varied symptoms. Early suspicion and molecular testing in this case confirmed leptospirosis, leading to successful treatment.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Leptospirosis is a zoonotic bacterial infection prevalent in Malaysia, presenting with diverse symptoms that can mimic other febrile illnesses.
- Transmission occurs through contact with water or soil contaminated by infected animal urine.
- The disease spectrum ranges from asymptomatic to severe, life-threatening multiorgan failure.
Observation:
- A 13-year-old girl with outdoor exposure presented with symptoms mimicking other febrile illnesses.
- Initial serological tests for leptospirosis were inconclusive.
- The patient developed septic shock on day 14 of illness.
Findings:
- High clinical suspicion for leptospirosis prompted enhanced antibiotic therapy with ceftriaxone.
- Molecular detection of leptospires in urine samples confirmed the diagnosis.
- The patient demonstrated significant improvement following appropriate treatment.
Implications:
- This case highlights the importance of considering leptospirosis in febrile illnesses, especially with a history of potential exposure.
- Molecular diagnostic techniques are crucial for timely and accurate leptospirosis diagnosis when serology is negative.
- Prompt and appropriate antibiotic treatment is vital for managing severe leptospirosis and preventing mortality.
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