Turkish Journal of Geriatrics 2013 , Vol 16, Issue 3
LEPTOSPIROSIS IN A GERIATRIC PATIENT WHO FREQUENTLY WALKS BAREFOOT ON THE BEACH
Vedat TURHAN1, Ergenekon KARAGÖZ1, Murat EROĞLU2, Asım ÜLÇAY1, Yalçın ÖNEM3, Erdinç ATABEK4
1Gata Haydarpaşa Eğitim Hastanesi, Enfeksiyon Hastalıkları Ve Klinik Mikrobiyoloji Servisi İSTANBUL
2Gata HaydarpaÅŸa EÄŸitim Hastanesi, Acil Servis Ä°STANBUL
3Gata Haydarpaşa Eğitim Hastanesi, İç Hastalıkları Servisi İSTANBUL
4Etlik Merkez Veteriner Kontrol Ve Araştırma Enstitüsü, Spiroket Laboratuarı ANKARA
Leptospirosis, a worldwide zoonosis manifesting itself in various types, is difficult to diagnose because of non-specific symptoms. A ninety-two year-old geriatric male patient was admitted to GATA Haydarpafla Training Hospital Emergency Department with complaints of high fever, sweating, fatigue, headache, muscle aches, nausea, vomiting and the inability to walk that continued for two days. In his anamnesis, he had been on vacation to Antalya, which is a coastal province on the southern coast of Turkey. Whilst on holiday, one of his activities was to walk on the beach for several hours barefoot. His complaints started 3 days on his return to Istanbul. Blood samples were sent to spirochete laboratory of Etlik Central Veterinary Control and Research Institute. He was discharged from the Institute on 100 mg of doxycycline and 500 mg of ciprofloxacin (bid, per oral). One week later, Institute reported that the antibodies for leptospira were positive. A microagglutination test confirmed the serovar Leptospira icterohaemorrhagiae, with the titers of 1:400. After two weeks of treatment, his physical examination and laboratory tests were found to be normal. In conclusion, a careful assessment of risk factors in the case history of the patient with non-spesific symptoms such as high fever, frontal headache, myalgia and conjunctival hyperemia will assist the diagnosis of leptospirosis. Laboratory results such as neutrophilia, thrombocytopenia, high degree of creatine kinase also play an important role in the diagnosis of the disease. Early treatment should be started as soon as possible to prevent further aggravation of the disease. Keywords : Leptospirosis; Weil Disease; Geriatrics