Are Pathogenic Leptospira Species Agents of Community-Acquired Pneumonia? Case Reports of Leptospirosis Presenting as Pneumonia

M Hussein Gasem; Helmia Farida; Ahmed Ahmed; Juliţte A Severin; Agus Suryanto; Bambang Isbandrio; Henri A Verbrugh; Rudy A Hartskeerl; Peterhans J van den Broek

doi:10.1128/JCM.02093-15

Are Pathogenic Leptospira Species Agents of Community-Acquired Pneumonia? Case Reports of Leptospirosis Presenting as Pneumonia

J Clin Microbiol. 2016 Jan;54(1):197-9. doi: 10.1128/JCM.02093-15. Epub 2015 Oct 28.

Authors

M Hussein Gasem¹, Helmia Farida², Ahmed Ahmed³, Juliţte A Severin⁴, Agus Suryanto⁵, Bambang Isbandrio⁶, Henri A Verbrugh⁴, Rudy A Hartskeerl³, Peterhans J van den Broek⁷

Affiliations

¹ Department of Internal Medicine, Faculty of Medicine Diponegoro University-Dr. Kariadi Hospital, Semarang, Central Java, Indonesia National Reference Laboratory for Leptospira, Dr. Kariadi Hospital, Semarang, Central Java, Indonesia [email protected].
² Department of Microbiology, Faculty of Medicine Diponegoro University-Dr. Kariadi Hospital, Semarang, Central Java, Indonesia.
³ KIT Biomedical Research, WHO/FAO/OIE and National Leptospirosis Reference Center, Royal Tropical Institute, Amsterdam, North Holland, The Netherlands.
⁴ Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, South Holland, The Netherlands.
⁵ Department of Internal Medicine, Faculty of Medicine Diponegoro University-Dr. Kariadi Hospital, Semarang, Central Java, Indonesia.
⁶ National Reference Laboratory for Leptospira, Dr. Kariadi Hospital, Semarang, Central Java, Indonesia Department of Microbiology, Faculty of Medicine Diponegoro University-Dr. Kariadi Hospital, Semarang, Central Java, Indonesia.
⁷ Department of Infectious Diseases, Leiden University Medical Center, Leiden, South Holland, The Netherlands.

Abstract

We report four Indonesian cases meeting the clinical and radiological criteria for community-acquired pneumonia and other findings suggestive of leptospirosis. Quantitative PCR (qPCR) analyses of serum and urine samples and serology confirmed the diagnosis of leptospirosis in each. Results of qPCR analysis of throat swabs were concordant with those obtained with acute-phase serum samples, which suggests its potential for use as a noninvasive diagnostic tool for leptospirosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antibodies, Bacterial / blood
Bacteriological Techniques
Community-Acquired Infections / diagnosis*
Community-Acquired Infections / microbiology
Community-Acquired Infections / pathology*
Humans
Leptospira / isolation & purification*
Leptospirosis / diagnosis*
Leptospirosis / microbiology
Leptospirosis / pathology*
Pharynx / microbiology
Pneumonia, Bacterial / etiology*
Pneumonia, Bacterial / microbiology
Pneumonia, Bacterial / pathology*
Real-Time Polymerase Chain Reaction
Serologic Tests
Serum / microbiology
Urine / microbiology

Substances

Antibodies, Bacterial

Grants and funding

The clinical study of community-acquired pneumonia, from which these four patients were derived, was funded by Royal Netherlands Academy of Arts and Sciences (KNAW) SPIN postdoc program no. 06-PD-17. The microbiology tests for CAP were funded by the Laboratory of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands. PCR and serology tests for the leptospires were funded by the Royal Tropical Institure (KIT), Amsterdam, The Netherlands.