Comparison of clinical and laboratory data between hantavirus infection and leptospirosis: a retrospective case series study in southern Taiwan.

Abstract

Leptospirosis (LS) and hantavirus (HV) are rodent-borne diseases and share similar clinical manifestations, posing diagnostic challenges. This retrospective study compared clinical characteristics, laboratory data, complications and outcomes of 33 LS and nine HV cases in Kaohsiung, Taiwan, from 2006 to 2021. Both LS and HV diseases had high rates of acute kidney injury (84.8% vs 66.7%) and hepatitis (65.6% vs 88.9%); LS showed more hyperbilirubinemia (70% vs 12.5% in HV, p=0.005), higher initial creatinine levels (2.9 vs 1.37, p=0.018) and elevated initial C-reactive protein (218.3 vs 28.6 mg/dl, p<0.001), but lower initial lymphocyte percentage (6.63% vs 14.2%, p=0.005) and platelets (138.7/mm3 vs 68.9, p=0.016) compared with HV. Microscopic hematuria was significantly more prevalent in LS (80% vs 28.65% in HV, p=0.016). Notably, the LS and HV groups exhibited statistically significant differences in thrombocytopenia (57.5% vs 100%, p=0.019), hyperbilirubinemia (70% vs 12.5%, p=0.005), shock (45.5% vs 0%, p=0.016) and hematuria (80% vs 28.6%, p=0.016). Neither group experienced fatalities. Fever, thrombocytopenia and acute kidney injury alert physicians to consider LS and HV for differential diagnosis. Elevated bilirubin, along with hematuria or shock, suggests a preferred diagnosis for LS.