Jacobs Journal of Clinical Case Reports

Acute Leptosperosis Associated With Epstein - Barr virus: Case report.

*Wael Nasser
Department Of Pediatrics, Baruch Padeh Poriya Medical Center Lower Galilee, Israel

*Corresponding Author:
Wael Nasser
Department Of Pediatrics, Baruch Padeh Poriya Medical Center Lower Galilee, Israel
Email:wael-nasser@hotmail.com

Published on: 2019-02-12

Abstract

Leptospirosis is an infectious disease of humans and animals; it is caused by corkscrew-shaped bacteria called Leptospira. Weil’s disease is the classic form of severe leptospirosis, and it is characterized by liver damage (causing jaundice), kidney failure, and bleeding. Leptospiral infection in humans causes signs and symptoms that can range from none to mild such as headaches, muscle pains, and fevers; too severe with bleeding from the lungs the most serious and life-threatening of all leptospirosis complications, additionally, the heart and brain can be affected ,meningitis of the outer layer of the brain, encephalitis of brain tissue. Most of the cases are mild leptospirosis, the rest experience severe disease. We present an isolated case of Weil’s disease and EBV in a 15-year-old girl, the girl was admitted to our department due to high fever, abdominal pain and vomiting, on evaluation she found to have jaundice, decreasing hemoglobin, increasing bilirubin with abnormal value of liver enzymes; other causes of disease were investigated and EBV infection and leptospirosis were determined by serologic tests. The patient’s status improved after she was started on antibiotics. Immunosuppression during active EBV infection has been reported previously, and therefore, this could have caused the severe symptoms after Leptospira infection in our case.

Keywords

EBV, LEPTOSPIRA, WEIL’S DISEASE, IMMUNOSUPPRESION.

Introduction

Leptospirosis is a zoonotic disease caused by a leptospira and it is transmitted by the urine of an infected animal and is contagious as long as the urine is still moist, humans become infected through contact with water, food, or soil that contains urine from these infected animals [1, 2]. This may happen by swallowing contaminated food or water or through skin contact. Occupations at risk include veterinarians, countryside rangers, slaughterhouse workers, farmers, sailors on rivers, sewer maintenance workers and people who work on derelict buildings [3]. The majority of patients with leptospirosis manifest a mild, anicteric febrile illness, but a minority of patients develops a severe form with multiorgan involvement called Weil’s disease the classic form of severe leptospirosis. Weil’s disease is characterized by high fever, liver damage causing jaundice, kidney failure, and bleeding [4-5]. Additionally, the heart and brain can be affected, meningitis of the outer layer of the brain, encephalitis of brain tissue with same signs and symptoms and pulmonary involvement considered as the most serious and life-threatening of all leptospirosis complications [5]. The infection is often incorrectly diagnosed due to the nonspecific symptoms. Overall, Weil’s syndrome has a mortality rate of 5% to 10%. Important causes of death include renal failure, cardiopulmonary failure and widespread hemorrhage [6]. Epstein-Barr virus (EBV) can induce immune responses in humans, which impair liver function. Weil’s disease associated with active EBV infection was described only in a few cases in the literature [7-8].