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The First Case of Leptospirosis with Initial Infection in Guam, United States, and Imported into Japan
1)Department of Internal Medicine, Itabashi Chuoh Medical Center, 2)Department of Infection Prevention and Control, Tokyo Medical University Hospital, 3)Department of Microbiology, Tokyo Medical University
Hiroaki FUJITA1)2)3), Itaru NAKAMURA2) & Tetsuya MATSUMOTO3)
(Received April 10, 2017)
(Accepted August 30, 2017)
Key words: Guam, leptospirosis

We report herein on what is, to our knowledge, the first case of leptospirosis infection acquired in Guam and imported into Japan. The patient was a 31-year-old Japanese man who stayed in Guam for 4 days in early January 2017. He initially experienced headache and high fever 10 days after returning to Japan, and was admitted our hospital 15 days after returning. On admission, he also had conjunctivitis, renal dysfunction, liver dysfunction, and proteinuria. He reportedly had gone mountain climbing in Guam and on the way getting off the mountain, he had lost his way and walked in the river. We suspected leptospirosis and began administering intravenous ceftoriaxione. However, Leptospira DNA was not detected in the blood collected at admission. His fever and other symptoms subsided within 3 days. A microscopic agglutination test was performed using serum collected on days 3 and 10. This revealed a greater-than-four-fold increase in antibody titers against several strains in serum collected on day 10 and the leptospirosis diagnosis was confirmed. Diverse activities can be undertaken when traveling abroad, and this case showed that not only waterborne activities but also climbing, which is seemingly unrelated to fresh water, also presents opportunities for infection. Accurate diagnosis depends on having as much information as possible concerning the worldwide infectious disease climate.

[ Kansenshogaku Zasshi 91: 968-971, 2017 ]

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