A Typical Presentation of Acute Meningitis in IcTeric Leptospirosis: A Case Report

Leptospirosis is an acute febrile zoonotic disease caused by pathogenic spirochetes of the genus Leptospira. It is an emerging disease in sub tropical and tropical countries. It transmitted to human via exposure of contaminated water or soil by infected animals. Clinical manifestations range from mild fever with flu-like symptoms to fulminant diseases such as Weil?s disease. Diagnosis confirmation made by isolating the organisms and positive serologic testing. We report a case of atypical presentation of acute meningitis in a 28 years old patient with icteric leptospirosis. Patient came with fever and predominantly neurological symptoms 5 days prior to admission. Patient was experiencing headache, neck stiffness, altered consciousness and seizures. Diagnosis was concurred when serology tests positive for Leptospira antibody supporting the clinical signs and symptoms. Patient was then given 3rd generation cephalosporin antibiotic therapy and supportive symptomatic therapy. Leptospirosis is often under diagnosed, associated manifestations may overlap with dengue and typhoid fevers which are more common. It is further complicated with poor access to accurate diagnostic tests especially in remote healthcare facility with limited access and availability. It is important for physician to be aware of the diverse and uncommon manifestations of this disease to able to make timely diagnosis. Prompt and adequate treatment are critical to shorten the duration of illness, reduce shedding of the organism and avoid severe complications.