Resumen de Serological evidence of leptospirosis in patients with a clinical suspicion of dengue in the State of Ceará, Brazil

Laiane Fernanda de Melo Bezerra, Raissa Matos Fontes, Almira Maria Monteiro Gomes, Dyana Alves da Silva, Jeová Keny Baima Colares, Danielle Malta Lima

• español

  Introducción. El dengue y la leptospirosis son dos enfermedades febriles de gran importancia clínica y epidemiológica en Brasil, y presentan una similitud sintomatológica significativa, lo cual dificulta el diagnóstico clínico.Objetivos. Hacer el diagnóstico diferencial para leptospirosis en pacientes con sospecha clínica de dengue.Materiales y métodos. En este estudio, 86 pacientes con sospecha clínica de dengue fueron sometidos a examen para el diagnóstico de dengue mediante pruebas de virología y serología (RT-PCR, prueba de inmunocromatografía NS1 y ELISA-NS1) y pruebas para la detección de IgM (prueba rápida IgM/IgG y ELISA-IgM). En los mismos pacientes también se evaluó la presencia de leptospirosis mediante la prueba rápida IgG/IgM (Bioeasy®) y ELISA IgM-Leptospira (PanBio®).Resultados. De los 86 pacientes, 48 (55,8 %) fueron positivos para dengue en, por lo menos, una de las pruebas y 5 (7,35 %) presentaron reacciones positivas para leptospirosis.Conclusión. Durante las epidemias de dengue, otras infecciones y entre ellas la leptospirosis, pueden dar lugar a confusiones cuando se el diagnóstico se hace únicamente con base en criterios inespecíficos clínicos y de laboratorio.

• English

  Introduction: Dengue and leptospirosis are two febrile illnesses of great clinical and epidemiological importance in Brazil. Their significant degree of symptomatic similarity makes clinical diagnosis difficult.Objective: To diagnose leptospirosis differentially in patients with clinically suspected dengue.Materials and methods: In this study, 86 patients with clinically suspected dengue underwent virological and serological diagnostic evaluations for dengue (reverse transcriptase polymerase chain reaction, NS1 immunochromatographic test, and NS1 enzyme-linked immunosorbent assay, ELISA), as well as tests to detect immunoglobulin M (IgM; IgM/IgG Rapid Test and IgM ELISA). The same patients were subsequently evaluated for leptospirosis using Rapid Test IgG/IgM (Bioeasy®) and Leptospira IgM ELISA (PanBio®).Results: Of the 86 patients, 48 (55.8%) had positive results for dengue in at least one of the tests and five (7.35%) showed positive reactions for leptospirosis.Conclusion: During dengue epidemics, this disease may be misdiagnosed as other infections, including leptospirosis, when diagnosis is based on nonspecific clinical and laboratory criteria alone.

• português

  Introduction: Dengue and leptospirosis are two febrile illnesses of great clinical and epidemiological importance in Brazil, demonstrating significant symptomatic similarity that makes clinical diagnosis difficult.Objectives: To differentially diagnose leptospirosis in patients with clinically suspected dengue.Materials and methods: In this study, 86 patients with clinically suspected dengue underwent virological and serological diagnostic evaluations for dengue (reverse transcriptase polymerase chain reaction, NS1 immunochromatographic test, and NS1 enzyme-linked immunosorbent assay [ELISA]), and tests to detect immunoglobulin M (IgM; IgM/IgG Rapid Test and IgM ELISA). Then, the same patients were also evaluated for leptospirosis using Rapid Test IgG/IgM (Bioeasy®) and Leptospira IgM ELISA (PanBio®).Results: Of the 86 patients, 48 (55.8%) had positive results for dengue in at least one of the tests and 5 (7.35%) showed positive reactions for leptospirosis.Conclusion: During dengue epidemics, diagnosis of dengue may be confused with other infections, among which is leptospirosis, when diagnosed only by using nonspecific clinical and laboratory criteria.