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Leptospirosis patient with AIDS: the first case reported
E de S Neves1, M M Pereira, M C Galhardo
1Hospital Evandro Chagas, Department of Bacteriology, Instituto Oswaldo Cruz/Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Revista Da Sociedade Brasileira De Medicina Tropical
|January 1, 1994
Summary
This case study reports on a patient with acquired immunodeficiency syndrome (AIDS) who experienced renal icterohemorrhagic leptospirosis. The infection did not worsen the patient's AIDS, showing a similar clinical course to non-immunocompromised individuals.
Area of Science:
- Infectious Diseases
- Immunology
- Nephrology
Background:
- Leptospirosis is a zoonotic disease caused by pathogenic Leptospira spirochetes.
- Acquired immunodeficiency syndrome (AIDS) is characterized by severe immunosuppression, increasing susceptibility to opportunistic infections.
- Renal involvement is a common complication of severe leptospirosis.
Observation:
- A patient diagnosed with AIDS presented with symptoms of icterohemorrhagic leptospirosis.
- The patient had significantly low CD4+ T lymphocyte counts, indicating advanced immunosuppression.
- Despite immunosuppression, the patient's clinical presentation of leptospirosis mirrored that of non-immunocompromised patients.
Findings:
- The leptospirosis infection did not lead to a discernible worsening of the patient's underlying AIDS.
- Serological testing confirmed Leptospira infection, with a positive microscopic agglutination test showing a maximum titer of 1:3,200.
- Leptospira interrogans was persistently detected in urine cultures for two months, while blood cultures remained negative.
Implications:
- This case suggests that patients with AIDS may tolerate leptospirosis without exacerbation of their immunodeficiency.
- The findings highlight the importance of considering leptospirosis in the differential diagnosis of febrile illnesses in patients with AIDS, even with low CD4 counts.
- Persistent urinary shedding of Leptospira in an immunocompromised host warrants further investigation into transmission dynamics.