Abstract
BackgroundLeptospirosis is a reemerging zoonosis with a worldwide distribution and a wide range of clinical manifestations. We report a case of leptospirosis meningitis in a previously healthy woman infected by her pet mouse.Case presentationA 27-year-old Caucasian woman with pet mice presented to our institute with a 1 week history of fever, headache, myalgia, vomiting, diarrhea, and dark urine. Her admission examination revealed neck stiffness, conjunctivitis, and icteric sclera. Her liver enzymes, bilirubin, white blood cell count, and C-reactive protein were elevated. Her cerebrospinal fluid showed an elevated white blood cell count. Polymerase chain reactions using her cerebrospinal fluid, blood, and urine showed negative results for leptospirosis, but the result of her microagglutination test was positive for Leptospira interrogans serovar sejroe with a more than threefold increase in paired sera. The patient was treated with ceftriaxone for 1 week, and her condition steadily improved.ConclusionsThis case report raises awareness of pet rodents as sources of leptospirosis. Leptospirosis meningitis should be considered in patients with meningeal symptoms and pet rodents.
Highlights
Leptospirosis is a reemerging zoonosis with a worldwide distribution and a wide range of clinical manifestations
A recent review on leptospirosis meningitis revealed that almost all patients (N = 366 adults) presented with fever (98%), headache (94%), and neck stiffness (93%) [13]
We describe a Nordholm et al Journal of Medical Case Reports (2019) 13:362 case of leptospirosis meningitis in a young, previously healthy woman who was most likely infected by her pet mouse
Summary
Leptospirosis is a reemerging zoonosis that occurs worldwide and is believed to be underdiagnosed because of challenging diagnostics and a wide clinical spectrum of disease [1]. Case presentation A 27-year-old Caucasian woman with an unremarkable medical history was admitted to a local hospital because of 1 week of fever, lower back pain, and cough Since her fifth day of disease, she had experienced severe headache, ear and eye pain, and yellowish eyes. The patient’s physical examination revealed neck stiffness, conjunctivitis, and icteric sclera Her blood pressure was 113/65 mmHg, heart rate was 79 beats/minute, temperature was 38.1 °C, respiratory rate was 16 breaths/minute, and oxygen saturation was 98% without oxygen supplementation. The result of her CSF culture was negative Her blood and urine were examined on day 7 of disease with polymerase chain reaction (PCR) tests that showed negative results for leptospirosis.
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