Leptospirosis diagnosis among patients suspected of dengue fever in Brazil
Abstract Background: The early symptoms of leptospirosis and dengue fever are difficult to distinguish and can cause diagnostic confusion. Due to the large dengue epidemics that has occurred in Brazil in recent years, it is possible that cases of leptospirosis were unreported. Therefore, we performe...
Published in: | Journal of Venomous Animals and Toxins including Tropical Diseases |
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ftdoajarticles:oai:doaj.org/article:a9f359fdb5c0454e8570c5a91a9a3dad 2023-05-15T15:15:41+02:00 Leptospirosis diagnosis among patients suspected of dengue fever in Brazil Felipe Fornazari Virgínia Bodelão Richini-Pereira Sâmea Fernandes Joaquim Pedro Gabriel Nachtigall Helio Langoni https://doi.org/10.1590/1678-9199-jvatitd-2020-0118 https://doaj.org/article/a9f359fdb5c0454e8570c5a91a9a3dad EN eng SciELO http://www.scielo.br/pdf/jvatitd/v27/1678-9199-jvatitd-27-e20200118.pdf http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992021000100502&tlng=en https://doaj.org/toc/1678-9199 1678-9199 doi:10.1590/1678-9199-jvatitd-2020-0118 https://doaj.org/article/a9f359fdb5c0454e8570c5a91a9a3dad Journal of Venomous Animals and Toxins including Tropical Diseases Leptospira Microscopic agglutination test PCR Unreported disease Zoonosis Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 article ftdoajarticles https://doi.org/10.1590/1678-9199-jvatitd-2020-0118 2022-12-31T14:37:29Z Abstract Background: The early symptoms of leptospirosis and dengue fever are difficult to distinguish and can cause diagnostic confusion. Due to the large dengue epidemics that has occurred in Brazil in recent years, it is possible that cases of leptospirosis were unreported. Therefore, we performed a retrospective study to detect leptospirosis in patients who were tested for dengue, but whose laboratory diagnoses were negative. Methods: Sera samples from 2,017 patients from 48 cities located in the central region of São Paulo state, Brazil, were studied. All samples were subjected to the microscopic agglutination test (MAT), 305 of which were taken from patients five days or less since the onset of symptoms, and were additionally subjected to real-time polymerase chain reaction (PCR). Results: The overall prevalence of leptospirosis cases was 21 (1.04%), with 20 through MAT (18 for Icterohaemorrhagiae and two for the Cynopteri serogroup) and one through PCR (amplicon sequencing compatible with Leptospira interrogans). According to previously established criteria, eight cases of leptospirosis were classified as “confirmed” and 13 as “probable”. The Brazilian notification system for health surveillance had no records for 16 patients positive for leptospirosis and, thus, they were considered unreported cases. Statistical analyses revealed that the prevalence of leptospirosis was higher in men (1.56%) than in women (0.56%), and the mean age was higher in positive patients (43.7 years) than in negative ones (32.3 years). Conclusion: The results indicated that patients suspected of dengue fever had evidence of leptospirosis or Leptospira infection, and most of these cases were unreported in the Brazilian notification system. The high burden of dengue may contribute to the misdiagnosis of leptospirosis, and health professionals should increase their awareness of leptospirosis as an important differential diagnosis of patients with suspicion of dengue. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Journal of Venomous Animals and Toxins including Tropical Diseases 27 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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Leptospira Microscopic agglutination test PCR Unreported disease Zoonosis Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 |
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Leptospira Microscopic agglutination test PCR Unreported disease Zoonosis Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 Felipe Fornazari Virgínia Bodelão Richini-Pereira Sâmea Fernandes Joaquim Pedro Gabriel Nachtigall Helio Langoni Leptospirosis diagnosis among patients suspected of dengue fever in Brazil |
topic_facet |
Leptospira Microscopic agglutination test PCR Unreported disease Zoonosis Arctic medicine. Tropical medicine RC955-962 Toxicology. Poisons RA1190-1270 Zoology QL1-991 |
description |
Abstract Background: The early symptoms of leptospirosis and dengue fever are difficult to distinguish and can cause diagnostic confusion. Due to the large dengue epidemics that has occurred in Brazil in recent years, it is possible that cases of leptospirosis were unreported. Therefore, we performed a retrospective study to detect leptospirosis in patients who were tested for dengue, but whose laboratory diagnoses were negative. Methods: Sera samples from 2,017 patients from 48 cities located in the central region of São Paulo state, Brazil, were studied. All samples were subjected to the microscopic agglutination test (MAT), 305 of which were taken from patients five days or less since the onset of symptoms, and were additionally subjected to real-time polymerase chain reaction (PCR). Results: The overall prevalence of leptospirosis cases was 21 (1.04%), with 20 through MAT (18 for Icterohaemorrhagiae and two for the Cynopteri serogroup) and one through PCR (amplicon sequencing compatible with Leptospira interrogans). According to previously established criteria, eight cases of leptospirosis were classified as “confirmed” and 13 as “probable”. The Brazilian notification system for health surveillance had no records for 16 patients positive for leptospirosis and, thus, they were considered unreported cases. Statistical analyses revealed that the prevalence of leptospirosis was higher in men (1.56%) than in women (0.56%), and the mean age was higher in positive patients (43.7 years) than in negative ones (32.3 years). Conclusion: The results indicated that patients suspected of dengue fever had evidence of leptospirosis or Leptospira infection, and most of these cases were unreported in the Brazilian notification system. The high burden of dengue may contribute to the misdiagnosis of leptospirosis, and health professionals should increase their awareness of leptospirosis as an important differential diagnosis of patients with suspicion of dengue. |
format |
Article in Journal/Newspaper |
author |
Felipe Fornazari Virgínia Bodelão Richini-Pereira Sâmea Fernandes Joaquim Pedro Gabriel Nachtigall Helio Langoni |
author_facet |
Felipe Fornazari Virgínia Bodelão Richini-Pereira Sâmea Fernandes Joaquim Pedro Gabriel Nachtigall Helio Langoni |
author_sort |
Felipe Fornazari |
title |
Leptospirosis diagnosis among patients suspected of dengue fever in Brazil |
title_short |
Leptospirosis diagnosis among patients suspected of dengue fever in Brazil |
title_full |
Leptospirosis diagnosis among patients suspected of dengue fever in Brazil |
title_fullStr |
Leptospirosis diagnosis among patients suspected of dengue fever in Brazil |
title_full_unstemmed |
Leptospirosis diagnosis among patients suspected of dengue fever in Brazil |
title_sort |
leptospirosis diagnosis among patients suspected of dengue fever in brazil |
publisher |
SciELO |
url |
https://doi.org/10.1590/1678-9199-jvatitd-2020-0118 https://doaj.org/article/a9f359fdb5c0454e8570c5a91a9a3dad |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Journal of Venomous Animals and Toxins including Tropical Diseases |
op_relation |
http://www.scielo.br/pdf/jvatitd/v27/1678-9199-jvatitd-27-e20200118.pdf http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-91992021000100502&tlng=en https://doaj.org/toc/1678-9199 1678-9199 doi:10.1590/1678-9199-jvatitd-2020-0118 https://doaj.org/article/a9f359fdb5c0454e8570c5a91a9a3dad |
op_doi |
https://doi.org/10.1590/1678-9199-jvatitd-2020-0118 |
container_title |
Journal of Venomous Animals and Toxins including Tropical Diseases |
container_volume |
27 |
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1766346034810716160 |