Quaiser Saif, Khan Ruhi and Vishwanath Arun
Leptospirosis is one of the most common zoonotic diseases, that is potentially fatal but it is quite underdiagnosed and under reported. However, acute necrotizing pancreatitis, which is usually associated with high mortality rate, is a rare complication of leptospirosis. This is a report of leptospirosis case presenting with acute pancreatitis. A previously healthy 35 year old male Indian farmer presented to the emergency department with chief complaints of high grade fever, chills and rigors but no rash for the last 3 days. There was no history of cough, breathlessness, pain abdomen, vomiting, hemoptysis or haematemesis, altered sensorium or burning micturition. There was no history of any addiction or previous hospitalization. Respiratory, cardiovascular and neurological systems examination was normal. Leptospira IgM Elisa was undertaken on the 7th day of admission, which was found to be positive. IgG negative and a Leptospira microagglutination test was also positive (at 1/200, L. icterohemorrhagica). Severe leptospirosis may be fatal before IgM antibody is reliably produced; furthermore, leptospiremia may be difficult to detect due to negative serologic results and blood cultures. Therefore, repeat serology after the first week of illness and empirical treatment prior to serologic results may be essential for improving outcome in patients with severe leptospirosis.
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