Title : Co-infection of severe leptospirosis and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with multiple organ involvement in indonesia
Leptospirosis co-infection and the pathogenesis of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) play a significant part in the emergence and progression of SARS-CoV-2 infection by enhancing the difficulty of identification, management, and outcome of COVID-19 well as worsening disease severity and death.
We presented a 53-year-old man with severe Leptospirosis and diagnosed with severe SARS COV-2 Delta variant during the pandemic. He was admitted to the Hospital with moderate ARDS (Acute Respiratory Distress Syndrome), hypovolemic shock, bleeding manifestation, thrombocytopenia, multiple organ involvement such as acute kidney injury and liver failure. The Covid-19 antigen rapid test and Rapid Lateral Flow were negative in the first treatment day. Reverse-transcription Polymerase Chain Reaction (RTPCR) finally was used to establish COVID-19, and Microscopic Agglutination Test (MAT) was carried out and repeated with interval 7 days to confirm the diagnosis of Leptospirosis. The patient was treated with functional, supportive care for COVID-19 such as Plasma Convalescent and antibiotic therapy for leptospirosis. The patient was given medication and guidance for 15 days before being discharged from the hospital with clinical and laboratory improvements.
To highlight the importance of microbial co-infection in COVID-19, we outline the co-infection of bacteria with SARS-CoV-2, their effects on COVID-19, the grounds for co-infection, and their identification. Leptospirosis is one of the diagnoses that should be considered in especially developing countries in patients presenting with findings that may be confused with COVID-19 during the pandemic period.
Keywords: COVID-19, Co-infection, Leptospirosis, SARS-CoV-2 Delta Variant
Audience take away:
- To highlight the importance of microbial co-infection in COVID-19 during pandemic in the tropic area.
- This case report will help the medical doctor especially in the developing countries to consider that there might be co-infection of bacteria such as Leptospirosis with
SARS-CoV-2. Their co-infection can cause one of them to be misdiagnosed; medical doctors in tropical areas should be knowledgeable of the commonalities between these two diseases, particularly the early diagnostic presentation and pathogenesis. It is also necessary to highlight how critical it is to distinguish between these two disorders during the condition's early stages.
- This case report will help the audience to improve their knowledge in management co-infection of Leptospirosis and Covid-19 with multiple organ involvement.