A 45-year-old man, a farmer, presents with acute onset of a disease. He complains of headache, high temperature, pain in the gastrocnemius muscles, icteric face, and dark urine. Objectively: body temperature – 38°C. blood pressure – 100/70 mm Hg, conjunctival hemorrhages, hepatosplenomegaly, and oliguria. What is the most likely provisional diagnosis?

Answer options

1. Leptospirosis
2. Brucellosis
3. Trichinosis
4. Viral hepatitis
5. Pseudotuberculosis

Explanation

A 45-year-old man, a farmer, presents with acute onset of a disease. He complains of headache, high temperature, pain in the gastrocnemius muscles, icteric face, and dark urine. Objectively: body temperature – 38°C. blood pressure – 100/70 mm Hg, conjunctival hemorrhages, hepatosplenomegaly, and oliguria. What is the most likely provisional diagnosis?Symptoms The signs and symptoms of leptospirosis usually appear suddenly, about 5 to 14 days after infection. However, the incubation period can range from 2 to 30 days, according to the CDC. Mild leptospirosis Signs and symptoms of mild leptospirosis include: fever and chills coughing diarrheavomiting or both headache muscle pain particularly lower back and calvesa rashred and irritated eyes jaundice.Severe leptospirosis Signs and symptoms of severe leptospirosis will appear a few days after mild leptospirosis symptoms have disappeared. Symptoms depend on which vital organs are involved. It can lead to kidney or liver failure, respiratory distress, and meningitis. These can be fatal.The heart, liver, and kidneysIf leptospirosis affects the heart, liver, and kidneys, the person will experience: fatigue irregularoften fastheartbeat muscle pains nausea nosebleedspain in the chest panting poor appetite swelling of the hands, feet, or ankles unexplained weight loss jaundice, seen in a yellowing of the whites of the eyes, tongue, and skin Without treatment, this can lead to life-threatening kidney failure.The brain If it affects the brain or spinal cord, meningitis, encephalitis, or both may develop. Meningitis is an infection of the membrane covering the brain and spinal cord, while encephalitis refers to infection of brain tissue. Both conditions have similar signs and symptoms.These may include:confusion or disorientationdrowsinessfits or seizureshigh fevernauseaphotophobia, or sensitivity to lightproblems with physical movementsstiff neckinability to speakvomitingaggressive or unusual behaviorUntreated meningitis or encephalitis can result in serious brain damage, and it may be life-threatening.The lungsIf it affects the lungs, the person cannot breathe.Signs and symptoms include:high feverpantingcoughing up bloodIn severe cases, there may be so much blood that the person suffocates.