Pulmonary involvement in leptospirosis: a diagnostic enigma.

Leptospirosis is spirochetal zoonosis. It is endemic in India and pulmonary manifestations of this disease remain under-recognised. We describe a case with leptospirosis with pulmonary manifestations and highlight the importance of its early and accurate diagnosis. The case also highlights the importance of considering leptospirosis in the differential diagnosis in patients presenting with febrile illness and pulmonary manifestations.

Guillain-Barré syndrome: association with Campylobacter jejuni and Mycoplasma pneumoniae infections in India.

BACKGROUND: Guillain-Barré syndrome is the most common cause of acute neuromuscular paralysis and is considered a post-infectious disease. METHODS: Twenty patients with Guillain-Barré syndrome admitted to the Neurosciences Centre at the All India Institute of Medical Sciences from November 1997 to August 1998 were investigated for evidence of antecedent infections. This case-control study included 2 controls for each patient, one a household control and the other an age- and sex-matched hospital control suffering from a neurological illness other than Guillain-Barré syndrome. Evidence of recent Campylobacter jejuni infection was investigated by culture and serology, and for Mycoplasma pneumoniae by serology. RESULTS: There was evidence of recent C. jejuni infection in 35% of the patients compared with 25% of household controls and none of the hospital controls. M. pneumoniae infection was seen in 50% of patients compared with 25% of household controls and 15% of hospital controls. About one-third of the patients (30%) had evidence of both infections. The association of both infections in patients was found to be statistically significant as compared to hospital controls. CONCLUSION: C. jejuni and M. pneumoniae may be important antecedent illnesses in patients with Guillain-Barré syndrome in India.