Anicteric leptospirosis: An unusual cause of acute pancreatitis: Anicteric leptospirosis: An unusual cause of acute pancreatitis

Ruhi Khan; Saif Quaiser; Fatima Khan

Authors

Ruhi Khan Department of Medicine, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh India
Saif Quaiser Department of Medicine, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India
Fatima Khan Department of Microbiology, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India

Keywords:

Anicteric, leptospirosis, necrosis, pancreatitis, renal failure, thrombocytopenia

Abstract

Leptospirosis is one of the most common zoonotic diseases that are potentially fatal but it is quite under-diagnosed and under-reported. However, acute necrotizing pancreatitis, which is usually associated with high mortality rate, is a rare complication of leptospirosis. This is a report of leptospirosis case presenting with acute pancreatitis. A previously healthy 35-year-old male Indian farmer presented to the emergency department with chief complaints of high-grade fever, chills, and rigors but no rash for the last 3 days. There was no history of a cough, breathlessness, pain abdomen, vomiting, hemoptysis or hematemesis, altered sensorium, or burning micturition. There was no history of any addiction or previous hospitalization. Respiratory, cardiovascular and neurological system examination was normal. Leptospira IgM ELISA was undertaken on the 7 th day of admission, which was found to be positive. IgG negative and a Leptospira microagglutination test was also positive (at 1/200, Leptospira icterohemorrhagica) pyogenes. Severe leptospirosis may be fatal before IgM antibody is reliably produced; furthermore, leptospiremia may be difficult to detect due to negative serologic results and blood cultures. Therefore, repeat serology after the 1 st week of illness and empirical treatment prior to serologic results may be essential for improving outcome in patients with severe leptospirosis.

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Anicteric leptospirosis: An unusual cause of acute pancreatitis