Which conditions should be included in the differential diagnoses of leptospirosis?

Updated: Jul 08, 2021
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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The differential diagnosis of leptospirosis is confoundingly broad. The flulike illness that characterizes mild cases may resemble a benign viral syndrome, while more severe cases may resemble meningitis or sepsis. Dengue, in particular, and chikungunya often overlap in territory with leptospirosis, and more than one infection may be present.

Recognizing and addressing the differential diagnoses when evaluating a patient suspected of having leptospirosis is critical. Missing other life-threatening illnesses, such as bacterial meningitis, acute toxin-induced hepatitis, pancreatitis, cholangitis, or Goodpasture disease, can be devastating, particularly because each of those diseases has a specific and entirely different necessary therapy. In addition, delayed treatment for severe leptospirosis may negatively affect patient outcome.

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