Table 2.
Characteristics of cases clinically misdiagnosed as leptospirosis
| No | Leptospira symptoms | Other symptomsa | Leptospira Standard of Care Results at sites | Leptospira Reference Lab | Final pathogen identified & Lab results | |
|---|---|---|---|---|---|---|
| 1 | Icterus | 2,5,6,9,13,14,17,18, 19,20,21, 22 | Rapid IgM (neg) |
PCR negative IgM ELISA negative |
UNK | |
| 2 | Icterus, suffusion, brown-colored urine | 2,4,5,6,7,10,13,14,16,17,18,19,20 | IgM ELISA, low titer (Conv) |
PCR negative IgM ELISA negative |
R. typhi |
PCR Positive IgM (0.9–4.7) IgG (2.8–15.2) IFA Pos |
| 3 | 1,5,10,12 | Not done |
PCR negative IgM ELISA negative |
UNK | ||
| 4 | Gastrocnemius pain, Icterus | 2,5,10,13,16,19,20, 22 | Rapid IgM negative |
PCR negative IgM ELISA negative |
UNK | |
| 5 | Flank pain | 2,13,14 | Rapid IgM positive, MAT negative |
PCR negative IgM ELISA negative |
R. typhi |
PCR Negative IgM (1.3–12.8) IgG (0.4–3.2) IFA Pos |
| 6 | 2,5,6,9,13,19 | Rapid IgM positive |
PCR negative IgM ELISA negative |
UNK | ||
| 7 | 3,4,6,12,13,14,17,18,20 | Rapid IgM positive |
PCR negative IgM ELISA negative |
R. typhi |
PCR Positive IgM (2.3–8.9) IgG (1.5–10.1) IFA Pos |
|
| 8 | Icteric, suffusion | 1,4,11,13,19 | Rapid IgM positive, MAT negative |
PCR negative IgM ELISA negative |
S. aureus | Blood culture |
| 9 | 2,3,4,13,16,17,19,20,22 | Rapid IgM negative |
PCR negative IgM ELISA titer 1:100 convalescent sera |
Chikungunya |
PCR Negative IgM (6.4–3.3) IgG (0.2–3.0) |
|
| 10 | Suffusion | 3,5,8,10,13.14.20 | Rapid IgM positive |
PCR negative IgM ELISA negative |
UNK | |
| 11 | Gastrocnemius pain, brown-colored urine, suffusion | 2,5,9, 16,17,18,19 | Rapid IgM positive, MAT negative |
PCR negative IgM ELISA borderline |
UNK | |
| 12 | Brown-colored urine, suffusion | 2,3,4,5,10,13,14,18,20 | Rapid IgM positive, MAT negative |
PCR negative IgM ELISA negative |
R. typhi |
PCR Negative IgM (0.4–1) IgG (2.7–13.4) IFA Pos |
| 13 | 6,13,20 | Rapid IgM positive |
PCR negative IgM ELISA borderline |
Dengue |
PCR Positive DENV-3 NS1 positive IgM (6.335–3.819) IgG (12.371–12.931) |
|
| 14 | Suffusion | 3,16,23,19,20 | Rapid IgM positive, MAT inconclusive |
PCR negative IgM ELISA negative |
UNK | |
| 15 | Gastrocnemius pain | 13,14,15 | Rapid IgM positive |
PCR negative IgM ELISA titer 1:100 in acute and convalescent sera |
UNK | |
a1: decrease of consciousness; 2: chills; 3: lethargy; 4: anorexia; 5: headache; 6: dizziness; 7: epistaxis; 8: runny nose; 9: sore throat; 10: cough; 11: rhonchi; 12: shortness of breath; 13: nausea; 14: vomiting; 15: diarrhea; 16: constipation; 17: abdominal pain; 18: epigastric pain; 19: arthralgia; 20: myalgia; 21: itchy; 22: ecchymosis; 23: hematemesis