Infections and the Kidney

Global infections are very frequent cause of AKI. Often this is due to the non-specific systemic effects of sepsis and volume depletion and therefore can occur with many infectious agents perhaps most searingly brought to our attention with the SARS-CoV-2 pandemic. The kidney can also be damaged by infections directly involving the renal parenchyma, because of persistent infection elsewhere in the body, as a post-infectious response and secondary diseases causing obstruction. Identifying, first, that kidney injury is due to infection and the particular infection causing the patient's presentation is critical to management. Some infections discussed in this chapter are confined to specific areas of the world, but with increasing global travel and migration, patients may present to healthcare facilities anywhere;thus, a thorough travel history is invaluable. © Springer Nature Switzerland AG 2014, 2022.

Detection of Leptospira DNA among Post-Mortem Specimens during Covid-19 Pandemic

Intro: Leptospirosis is an emerging zoonosis with a global health concern. In Malaysia, leptospirosis incidence remains significant, since its first gazettement as a compulsorily notifiable disease in 2010. However, the prevalence of this disease among local forensic cases is unknown. Therefore, the present study aimed to determine the frequency of human leptospirosis among post-mortem specimens. Method(s): Archived forensic specimens referred to the Institute for Medical Research (IMR), Malaysia between January 2020 and December 2021 were retrieved. DNA from the specimens were extracted using an automated MagNA Pure 96 instrument and subjected to in-house qPCR targeting LipL32 gene and 16S rRNA gene of the pathogenic group of Leptospira spp. Amplification of RNaseP gene was included as internal amplification control (IAC). Finding(s): A total of 408 forensic specimens from 365 patients were received during the study period. Majority of the specimens were blood (n = 195, 47.8%), followed by tissue (n = 136, 33.3%) and liver (n = 59, 14.5%). Of the tested specimens, 2.2% (n = 9) were positive for leptospiral DNA. These positive specimens belonged to 9 different patients, of which the vast majority were male (n = 8, 88.9%), with an average age of 37.5 years. Conclusion(s): Albeit low detection of leptospiral DNA among forensic specimens in Malaysia, this study highlighted that majority of the positive patients were males of productive age.Copyright © 2023

A rare case of complicated pancreatitis due to leptospirosis.

The COVID-19 pandemic and the actions taken to combat it have greatly impacted the health infrastructure of all nations. Here we present a rare case of leptospirosis with severe acute pancreatitis, bilateral peripheral gangrene, disseminated intravascular coagulopathy and multiorgan failure. This is a rare presentation of leptospirosis wherein the patient had no history suggestive of acquisition of leptospires. The patient was started on doxycycline but still could not be saved due to the multisystem involvement.

A case of combined course of leptospirosis and coronavirus infection COVID-19.

A clinical case of a combined course of leptospirosis and coronavirus infection in a 71-year-old patient is presented. One of the features of this case was the difficulty of confirming the clinical diagnosis of leptospirosis in the absence of a typical clinical picture of this disease. Only the data of the epidemiological history and manifestations of the disease atypical for coronavirus infection allowed to suspect leptospirosis and confirm it by methods of specific laboratory diagnostics. The stages of differential diagnostic search in the practice of an infectious disease doctor are described.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

A case of combined course of leptospirosis and coronavirus infection COVID-19.

A clinical case of a combined course of leptospirosis and coronavirus infection in a 71-year-old patient is presented. One of the features of this case was the difficulty of confirming the clinical diagnosis of leptospirosis in the absence of a typical clinical picture of this disease. Only the data of the epidemiological history and manifestations of the disease atypical for coronavirus infection allowed to suspect leptospirosis and confirm it by methods of specific laboratory diagnostics. The stages of differential diagnostic search in the practice of an infectious disease doctor are described.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

A case of combined course of leptospirosis and coronavirus infection COVID-19

A clinical case of a combined course of leptospirosis and coronavirus infection in a 71-year-old patient is presented. One of the features of this case was the difficulty of confirming the clinical diagnosis of leptospirosis in the absence of a typical clinical picture of this disease. Only the data of the epidemiological history and manifestations of the disease atypical for coronavirus infection allowed to suspect leptospirosis and confirm it by methods of specific laboratory diagnostics. The stages of differential diagnostic search in the practice of an infectious disease doctor are described. © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

A case of combined course of leptospirosis and coronavirus infection COVID-19.

A clinical case of a combined course of leptospirosis and coronavirus infection in a 71-year-old patient is presented. One of the features of this case was the difficulty of confirming the clinical diagnosis of leptospirosis in the absence of a typical clinical picture of this disease. Only the data of the epidemiological history and manifestations of the disease atypical for coronavirus infection allowed to suspect leptospirosis and confirm it by methods of specific laboratory diagnostics. The stages of differential diagnostic search in the practice of an infectious disease doctor are described.Copyright © 2022 Interregional public organization Association of infectious disease specialists of Saint-Petersburg and Leningrad region (IPO AIDSSPbR). All rights reserved.

Severe Acute Pancreatitis Associated with Weil's Disease

Leptospirosis is an emerging zoonosis of worldwide importance. Its distribution is closely linked to hydrometric conditions. It is characterized by a wide clinical range, from the subclinical form, or one with few symptoms;which resolves spontaneously, to the multi-visceral form, known as icterrohemorrhagic disease or Weil's disease, with a lethal risk. All organs can be affected but with variable frequency. Pancreatic involvement is not well documented. We describe a 45-year-old man with Weil's disease associated with acute necrotizing pancreatitis. The evolution was favorable but required a three-week stay in the intensive care unit.

Possession of exotic animals and zoonotic diseases: an approach from the Mexican context

The possession of exotic animals as pets is a social practice that has become more visible in Mexico in recent years, so it is interesting to understand its environmental and social implications and those related to human health. The present study aims to identify the main species of exotic animals kept as pets and the zoonotic diseases reported in these species. We analyzed official figures of seizures of exotic fauna in Mexico and reviewed specialized literature on zoonotic diseases documented in Mexico in these species. We identified zoonoses in species of fauna that can be acquired legally and illegally in the country, reported in environments in which animals coexist with other species and are in direct contact with people, which represents an important factor in the spread and propensity of this type of disease. We conclude that the sanitary regulation of wildlife markets, the monitoring and studying microorganisms associated with wildlife are valuable strategies to prevent the emergence of zoonoses.

An exploratory qualitative enquiry into workers' experiences of leptospirosis and post-leptospirosis in Aotearoa New Zealand

Leptospirosis is a globally important, zoonotic bacterial disease with an estimated 1.03 million cases and 58,900 deaths annually, with tropical regions incurring the highest burdens.1 Humans are infected from contact with animal urine or from contaminated water;contact with rodents and floodwater are recognised risk factors globally2 Patients with acute leptospirosis episodes (ALEs) have diverse symptoms, ranging from undifferentiated fever to fatal disease.3 The clinical presentation is nonspecific, so diagnosis relies on attending clinicians being aware that leptospirosis could be a differential diagnosis followed by laboratory confirmation. The mechanisms underlying PLS may include persistent infection with Leptospira* post-infective fatigue syndrome9 or autoimmune conditions.10 Current reports on long COVID bring the importance of documenting the long-term sequelae of infectious diseases in greater focus.11 Choutka et al., in their 2022 review, coined the phrase post-acute infection syndromes (PAISs) to encompass viral, bacterial and protozoal infections where there is an unexplained failure to recover from the acute infection.12 These authors recognise the overlap of the clinical features of PAISs with myalgic encephalomyelitis/ chronic fatigue syndrome, suggesting a common etiopathogenesis. In Aotearoa, PLS is currently poorly, or not at all, recognised by ACC, thus documentation of patient experience with PLS will raise awareness of the condition and may also identify opportunities to improve systems and quality of care.21 The aim of this pilot study was to perform an exploratory qualitative study with participants who were suffering from PLS to document their experiences. [...]it has not been reviewed by one of the University's Human Ethics Committees.

Summaries

Feasibility study of brief Group Transdiagnostic Cognitive Behavioural Treatment delivered via Zoom for anxiety and depression in primary care Ben Beaglehole, Jenny Jordan, Chris Frampton, Alison Alexander, Angela Spencer, Cameron Lacey, Richard John Porter, Caroline J Bell Our study assesses whether it is feasible to deliver Transdiagnostic Cognitive Behavioural Therapy (TCBT) using Zoom for patients with anxiety and depression in primary care. A clinical review of monkeypox for the Aotearoa New Zealand clinician Teena Mathew, Eamon Duffy, Erasmus Smit, Jay narrower, Jeannie Oliphant, Noah Bunkley R Joan H Ingram, Rupert Handy, Annabelle Donaldson Mpox or previously known as monkeypox infection has been reported in Aotearoa New Zealand since July 2022 as part of the global outbreak mainly among individual identifying as gay, bisexual or other men who have sex with men. Airborne transmission: a new paradigm with major implications for infection control and public health Anna Stevenson, Joshua Freeman, MarkJermy Jason Chen At the start of the COVID-19 pandemic precautions against infection were based on the understanding that the virus would transmit largely by droplet spread.

Care of non COVID patients in COVID-19 era

The consequences of the COVID-19 pandemic are extensive and far-reaching. Non COVID communicable diseases continue to spread and non-communicable diseases continue to progress. People may access healthcare facilities little bit late due to fear of contracting COVID-19 and present with severe symptoms, even with complications. Nepal has been facing dual burden of both non-communicable and communicable diseases. The number of COVID-19 patients has continuously been rising in Nepal since the start of May 2020. There is an anticipated surge of infectious disease such as malaria, dengue fever, enteric fever, scrub typhus, leptospirosis during summer and monsoon seasons in Nepal. There will be surge of cases of acute undifferentiated febrile illness (AUFI) during monsoon. As fever is one of the very common symptoms of COVID-19, so COVID-19 needs to be considered in differential diagnoses of acute undifferentiated febrile illness. Copyright © 2020, Kathmandu University. All rights reserved.

Leptospirosis and COVID-19 co-infection case in Bangladesh.

Introduction: Leptospirosis, a zoonotic illness, is comparable to COVID-19 in that the majority of infections are mild or asymptomatic, and only a tiny percentage of those infected experience multiple system affected. Leptospirosis coinfection and the pathogenesis of SARS-CoV-2(Severe Acute Respiratory Syndrome Coronavirus 2) play a significant part in the emergence and progression of SARS-CoV-2 infection by enhancing the difficulty of identification, management, and outcome of COVID-19 well as worsening disease severity and death. Case report: We presented a 47-year-old individual with Leptospirosis diagnosed with SARS-CoV-2. A rapid test for IgM antibodies was used to confirm Leptospirosis. Reverse-transcription Polymerase Chain Reaction was used to establish COVID-19 (RTPCR). During the COVID-19 emergent crisis in Chattogram, Bangladesh, the person was diagnosed and treated with functional, supportive care for COVID-19 and antibiotic therapy for leptospirosis. The patient was given medication and guidance before being discharged from the hospital.To highlight the importance of microbial coinfection in COVID-19, we outline the coinfection of bacteria with SARS-CoV-2, their effects on COVID-19, the grounds for coinfection, and their identification.

An Overview of Anthropogenic Actions as Drivers for Emerging and Re-Emerging Zoonotic Diseases.

Population growth and industrialization have led to a race for greater food and supply productivity. As a result, the occupation and population of forest areas, contact with wildlife and their respective parasites and vectors, the trafficking and consumption of wildlife, the pollution of water sources, and the accumulation of waste occur more frequently. Concurrently, the agricultural and livestock production for human consumption has accelerated, often in a disorderly way, leading to the deforestation of areas that are essential for the planet's climatic and ecological balance. The effects of human actions on other ecosystems such as the marine ecosystem cause equally serious damage, such as the pollution of this habitat, and the reduction of the supply of fish and other animals, causing the coastal population to move to the continent. The sum of these factors leads to an increase in the demands such as housing, basic sanitation, and medical assistance, making these populations underserved and vulnerable to the effects of global warming and to the emergence of emerging and re-emerging diseases. In this article, we discuss the anthropic actions such as climate changes, urbanization, deforestation, the trafficking and eating of wild animals, as well as unsustainable agricultural intensification which are drivers for emerging and re-emerging of zoonotic pathogens such as viral (Ebola virus, hantaviruses, Hendravirus, Nipah virus, rabies, and severe acute respiratory syndrome coronavirus disease-2), bacterial (leptospirosis, Lyme borreliosis, and tuberculosis), parasitic (leishmaniasis) and fungal pathogens, which pose a substantial threat to the global community. Finally, we shed light on the urgent demand for the implementation of the One Health concept as a collaborative global approach to raise awareness and educate people about the science behind and the battle against zoonotic pathogens to mitigate the threat for both humans and animals.

The COVID-19 Mirage: A Young Biologist With an Atypical Presentation of a Zoonotic Disease During the COVID-19 Pandemic.

COVID-19 has become one of the main causes of febrile illness among emergency department patients and is always a differential diagnosis to keep in mind. Nonetheless, some patients with a history of exposure, persistent fever, and suspicion of COVID-19 end up having entirely different etiologies. Here, we present the case of a 29-year-old male biologist with an uncommon presentation of a zoonotic disease, characterized by unspecific signs and symptoms, which led to a delayed diagnosis, causing significant emotional distress in the patient. We also coin the term "COVID-19 Mirage," to serve as a constant reminder for clinicians of the effect that COVID-19 has caused on the differential diagnosis of fever of unknown etiology.

Leptospirosis Infection Misdiagnosed as COVID-19: A Rare Case Report.

Leptospirosis is an acute, febrile, systemic, and zoonotic infectious disease characterized by widespread vasculitis caused by Leptospira interrogans from the leptospira family. It can be in the form of asymptomatic infection; it can also progress with severe symptomatic forms characterized by multiorgan involvement such as aseptic meningitis as well as liver and kidney failure. Leptospirosis is transmitted to humans through water, soil, and food contaminated with the urine of infected mice or other mammals. COVID-19 is a newly detected coronavirus that causes pneumonia. The disease has led to a pandemic all over the world. In this case report, we aimed to draw attention to leptospirosis infection in the presence of a case who was followed up with the differential diagnosis of COVID-19 and diagnosed with leptospirosis during the COVID-19 pandemic. Leptospirosis is one of the diagnoses that should be kept in mind in especially developing countries in patients presenting with findings that may be confused with COVID-19 during the pandemic period.

The Investigation of Significant Leptospirosis Hotspots during the Initial COVID-19 Pandemic in the City of Jakarta, Indonesia

Leptospirosis is a common bacterial infection caused by pathogenic Leptospira spp.in tropical region, including in Indonesia. During the first year of COVID-19 pandemic, Jakarta reported a significant increase in leptospirosis cases. A study was conducted to analyze the distribution of leptospirosis and to identify hotspots of the leptospirosis. Leptospirosis notifications for the period of January to December 2020 were collected from the online surveillance database provided by the Provincial Health Office of Jakarta. Global and local spatial clustering at the village level across Jakarta was examined using Moran’s I and local indicators for spatial association (LISA). In 2020, total of 207 people infected by Leptospira spp. The highest number was recorded in January (n=142), accounting for 68.5% of the total reports over the period studied. The incidence was geographically dissimilar at village-level with the highest rates was observed in the west of the city. Moran’s I analysis demonstrates that leptospirosis incidence was significantly clustered (I = 0.191, p-value = 0.001). Total of 19 high-risk clusters in 9 sub-districts were identified and approximately 891,202 people were at higher risk of leptospirosis during the year of 2020. The findings suggest needs an improved disease surveillance to support spatially targeted interventions to control leptospirosis transmission.

Emerging canine leptospirosis in Sydney and the role of population demographics.

An outbreak of canine leptospirosis commenced in Sydney, Australia in 2017. The aim of this retrospective study was to determine if clusters of leptospirosis occurred during this outbreak, and if these were associated with host factors, to assist investigation of the drivers of emerging leptospirosis at this location. Within the City of Sydney local government area, 13 cases were reported during the outbreak. Administrative data on the canine population were collected and mapped. Clusters of leptospirosis cases were detected using a retrospective space-time analysis and a discrete Poisson probability statistical model. Sydney dog population registration [55.6%, 95% confidence interval (CI) 51.8-58.1%] was lower than the Australian national average (80%). The distribution of dog types, based on the United Kennel Club standards, was significantly (p < .0001) different to that of the national profile: there was a distinct preference in Sydney for companion dogs. The age distribution of dogs in Sydney did not reflect a typical right-skewed curve; instead, a relatively uniform distribution was observed between the age group of 1 to 8 years. A primary disease cluster (radius 1.1 km) in the eastern area of the Sydney City Council was identified (4 cases observed between 24 May and 9 August 2019 vs. 0.10 cases expected), p = .0450. When adjusted for the age, breed type and sex distribution of the population, similar clusters were identified; in the case of age-adjustment, the spatiotemporal cluster identified was larger and of longer duration (seven cases observed between 28 June and 11 November 2019 versus 0.34 cases expected), p = .0025. The presence of clusters of canine leptospirosis in the City of Sydney during this outbreak, which persisted after adjustment for demographics (age, sex, breed type), suggest that environmental factors - rather than host or pathogen factors - might be responsible for the emergence of leptospirosis. Environmental factors that potentially might be linked to this outbreak of canine leptospirosis and the clusters observed require investigation.