Introduction
Leptospirosis is a zoonotic disease caused by
leptospira, and is transmitted to humans by direct or
indirect exposure to urine or other body fluids of infected
animals. The clinical presentation in humans
ranges from a mild flu-like illness to a severe
illness with jaundice, meningitis, renal failure, pulmonary
hemorrhage. Epstein-Barr virus can induce complex humoral and cell-mediated immune responses in humans, which impair liver function, we describe and adult girl with leptospirosis associated with active EBV infection.
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Case report
A 14-year-old girl was admitted because of a 1-week
history of general malaise. Lymphadenophaty
no history of travel and had not taken any medicine in
the previous weeks,The patient’s body temperature was 39ºC, blood pressure was 110/70mmHg normal HR and normal RR.
his skin and sclera were icteric, cervical ,
lymphadenopathy, splenomegaly,
laboratory leukocytosis with high atypical lymphocytes, no anemia, mild thrombocytopenia, liver enzyme abnormality and cholestatic jaundice, normal renal function
Abdominal sonography showed mild
splenomegaly without other specific findings
The patient was treated with parenteral ceftriaxone and doxyline
Serum antibodies against hepatitis
A and serum surface antigen of hepatitis B were
negative. EBV serum immunoglobin
IgG and IgM were positive,
PCR IN URINE FOR :
Leptospira WASE POSOTIVE
Discussion
In general, the diagnosis
is initially based on clinical suspicion, and is confirmed
later by laboratory results, usually by the detection of
PCR IN URINE
The coinfection with EBV attributable to immunosuppression caused by active EBV infection. Increase the chans of hepatitis and another symptoms of liptospera.
