Leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis: Case report and systematic review
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...
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The Journal of Infection in Developing Countries
2024-08-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/18546 |
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| author | Manoj Kumar Panigrahi Shakti Kumar Bal Tara Prasad Tripathy Akshaya Moorthy Swadesh Kumar Mohanty Ashoka Mahapatra Sourin Bhuniya |
| author_facet | Manoj Kumar Panigrahi Shakti Kumar Bal Tara Prasad Tripathy Akshaya Moorthy Swadesh Kumar Mohanty Ashoka Mahapatra Sourin Bhuniya |
| author_sort | Manoj Kumar Panigrahi |
| collection | DOAJ |
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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.
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| format | Article |
| id | doaj-art-260a485bb4ac43d38ece7c0b822f54d0 |
| institution | OA Journals |
| issn | 1972-2680 |
| language | English |
| publishDate | 2024-08-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-260a485bb4ac43d38ece7c0b822f54d02025-08-20T02:14:20ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802024-08-01180810.3855/jidc.18546Leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis: Case report and systematic reviewManoj Kumar Panigrahi0Shakti Kumar Bal1Tara Prasad Tripathy2Akshaya Moorthy3Swadesh Kumar Mohanty4Ashoka Mahapatra5Sourin Bhuniya6Department of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, IndiaDepartment of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, IndiaDepartment of Radiodiagnosis & Imaging, All India Institute of Medical Sciences, Bhubaneswar, IndiaDepartment of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, IndiaDepartment of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, IndiaDepartment of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, IndiaDepartment of Pulmonary Medicine & Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India 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. https://jidc.org/index.php/journal/article/view/18546coinfectionleptospirosismelioidosisWeil’s diseasesosteoarticular infectionrespiratory failure |
| spellingShingle | Manoj Kumar Panigrahi Shakti Kumar Bal Tara Prasad Tripathy Akshaya Moorthy Swadesh Kumar Mohanty Ashoka Mahapatra Sourin Bhuniya Leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis: Case report and systematic review Journal of Infection in Developing Countries coinfection leptospirosis melioidosis Weil’s diseases osteoarticular infection respiratory failure |
| title | Leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis: Case report and systematic review |
| title_full | Leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis: Case report and systematic review |
| title_fullStr | Leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis: Case report and systematic review |
| title_full_unstemmed | Leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis: Case report and systematic review |
| title_short | Leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis: Case report and systematic review |
| title_sort | leptospirosis and melioidosis coinfection presenting as acute respiratory distress syndrome and osteomyelitis case report and systematic review |
| topic | coinfection leptospirosis melioidosis Weil’s diseases osteoarticular infection respiratory failure |
| url | https://jidc.org/index.php/journal/article/view/18546 |
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