Colorectal problem in leptospirosis

Document Type : Letter to the Editor

Authors

1 KMT Primary care center

2 Dr DY Patil University, Pune, India

Abstract

Dear, Editor, leptospirosis is an important zoonotic leptospiral infection. This infection is common and endemic in several tropical countries. The patients with leptospirosis usually have high fever and other systematic clinical problems such as renal failure and jaundice. The colorectal manifestation of leptospirosis is possible but little mentioned. Sometimes, the colorectal presentation of leptospirosis might be missed or incorrectly diagnosed. The good example is the missed diagnosis of leptospirosis as colon cancer [1]. Colon ulcer might be detected by colonoscopy study [1]. The pathogenesis is according to colonic spirochetosis pathological process. Direct colonic involvement might be shown by histological study. Indeed, the gastrointestinal symptoms including diarrhea is observable in cases with leptospirosis [2]. The patient might also have severe abdominal pain [2]. In severe case, abdominal CT scan might reveal pancolitis [3]. In fact, colon might be an affected organ in leptospirosis. In rare case, ischemia of colon is observable [4 - 5]. In any case with atypical clinical problem, colorectal manifestation might be a clinical feature of leptospirosis. The practitioner should recognize and consider this problem in any case from or having history of visiting to tropical endemic area.

Keywords

References

  1. Granito A, Ballardini G, Fusconi M, Volta U,  Muratori P, Sambri V, Battista G, Bianchi FB. A case of leptospirosis simulating colon cancer with liver metastases. World J Gastroenterol. 2004 Aug 15; 10(16): 2455–2456.
  2. Vijayachari P1, Sugunan AP, Singh SS, Mathur PP. Leptospirosis among the self-supporting convicts of Andaman Island during the 1920s--the first report on pulmonary haemorrhage in leptospirosis? Indian J Med Res. 2015 Jul;142(1):11-22.
  3. Maroun E, Kushawaha A, El-Charabaty E, Mobarakai N, El-Sayegh S. Fulminant Leptospirosis (Weil's disease) in an urban setting as an overlooked cause of multiorgan failure: a case report. J Med Case Rep. 2011 Jan 14;5:7.
  4. Jørgensen JC, Schlichting P, Agner E, Fischer A. Weil's disease with multiple organ failure and ischemia of the colon. Ugeskr Laeger. 1985 Oct 21;147(43):3407-8.
  5. Zamri Z, Shaker AH, Razman J. Leptospirosis complicating with acute large bowel gangrene: a case report. Clin Ter. 2012;163(5):399-400.
Iranian Journal of Colorectal Research
Volume 7, Issue 4
December 2019
Pages 1-1

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