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CORRESPONDENCE
Year : 2013  |  Volume : 138  |  Issue : 2  |  Page : 273

Diagnosis of leptospirosis


1 Wiwanitkit House, Bangkhae, Bangkok, Thailand
2 Hainan Medical University, China & Joseph Ayobabalola University, Nigeria & Faculty of Medicine, University of Nis, Serbia

Date of Web Publication3-Sep-2013

Correspondence Address:
Somsri Wiwanitkit
Wiwanitkit House, Bangkhae, Bangkok, Thailand

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Source of Support: None, Conflict of Interest: None


PMID: 24056608

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How to cite this article:
Wiwanitkit S, Wiwanitkit V. Diagnosis of leptospirosis. Indian J Med Res 2013;138:273

How to cite this URL:
Wiwanitkit S, Wiwanitkit V. Diagnosis of leptospirosis. Indian J Med Res [serial online] 2013 [cited 2019 Oct 22];138:273. Available from: http://www.ijmr.org.in/text.asp?2013/138/2/273/117547

Sir,

We read with interest the recent article on diagnosis of leptospirosis by Chaudhry et al[1] . The authors noted that "Seropositive and seronegative patients revealed no significant difference in clinical features and laboratory parameters" and also mentioned for co-infection with other tropical infections [1] . This report indicates the importance of specific laboratory testing for confirmation of leptospirosis. In fact, several tropical infections share common presentations with leptospirosis and the concurrent infection is also possible.Therefore, there is no process to rule out the possible concurrent infection and Chaudhry et al[1] also accepted that there were many cases with co-infections. Hence, the observed clinical features and laboratory parameters might be the result of a mixed infection, at least in some cases.

The conclusion that seropositivity has no relationship to clinical features and laboratory parameters must be carefully considered. The practitioner has to realize the limitation of presently available laboratory tests and the source of error in diagnosis [2] . For the widely used serological test, the important concern is on the cross-reactivity with other infections (such as syphilis and borreliosis [3] . The difference in diagnostic property can be observed in various diagnostic serological test kits available [4] . Additionally, the limitation of diagnosis can be expected in the acute phase of the disease due to lack of antibodies [2] . It has been shown that different laboratories in different clinical settings give different rates of accuracy in diagnosis [5] . Also, within an institute, the error due to specimen collection in pre-analytical phase can be expected [6] . Hence, the new technique based on molecular test is developed and available for clinical usage in some clinical settings. Nevertheless, for molecular diagnosis, the cost and availability are the main obstacles in real clinical practice in developing countries [2] .

 
   References Top

1.Chaudhry R, Das A, Premlatha MM, Choudhary A, Chourasia BK, Chandel DS, et al. Serological & molecular approaches for diagnosis of leptospirosis in a tertiary care hospital in north India: A 10-year study. Indian J Med Res 2013; 137 : 785-90.  Back to cited text no. 1
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2.Musso D, La Scola B. Laboratorydiagnosis of leptospirosis: A challenge. J Microbiol Immunol Infect 2013. In press.  Back to cited text no. 2
    
3.Trombert-Paolantoni S, Thomas P, Hermet F, Clairet V, Litou N, Maury L. Leptospirosis screening: performance of the Serion Elisa Classic Leptospira IgM KIT. Pathol Biol (Paris) 2010; 58 : 95-9.  Back to cited text no. 3
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4.Zochowski WJ, Palmer MF, Coleman TJ. An evaluation of three commercial kits for use as screening methods for the detection of leptospiral antibodies in the UK. J Clin Pathol 2001; 54 : 25-30.  Back to cited text no. 4
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5.Chappel RJ, Goris M, Palmer MF, Hartskeerl RA. Impact of proficiency testing on results of the microscopic agglutination test for diagnosis of leptospirosis. J Clin Microbiol 2004; 42 : 5484-8.  Back to cited text no. 5
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6.Wiwanitkit V. Types and frequency of preanalytical mistakes in the first Thai ISO 9002:1994 certified clinical laboratory, a 6 - month monitoring. BMC Clin Pathol 2001; 1 : 5.  Back to cited text no. 6
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