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Leptospirosis Cases in the Tokyo Metropolitan Area, Japan.

Jpn J Infect Dis; 2017 Sep 11.
Article in English | MEDLINE | ID: mdl-28890513


In Japan, 20-50 cases of leptospirosis are reported annually, typically involving farmers or returnees from tropical areas. Here, we report five indigenous leptospirosis cases that occurred in the Tokyo urban area. All cases were male (mean age 65.8 ± 4.7 years) and presented with clinical features including high fever, acute kidney injury, and jaundice. Three cases presented with pulmonary infiltration and ground glass opacity on admission. Two of the five patients were intubated and underwent continuous hemodiafiltration. The mean length of hospitalization was 38 ± 17.0 days, and all patients were treated with antibiotics. Notably, all patients had a history of exposure to rats prior to becoming symptomatic, suggesting that exposure to rats is a risk factor for urban leptospirosis. Although rare, even in metropolitan areas, leptospirosis should be considered by physicians when patients present with severe sepsis, acute kidney injury, and a history of exposure to rats.