{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:04:29Z","timestamp":1756425869393,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,12,13]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>We present the case of a young female landscaper who presented to an Australian tertiary hospital with persistent fevers and new pancytopenia. Extensive initial workup for her presenting illness did not identify a cause; however, a detailed history of her occupation revealed she worked heavily with soil on farms that had domestic livestock in addition to rodents. Hence, further serological testing for leptospirosis was performed, revealing a diagnosis of infection with Leptospira interrogans serovar Hardjo. Treatment covering leptospirosis was commenced, and she improved clinically, and her cell counts returned to normal. Pancytopenia is a rare manifestation of leptospirosis and has only been reported in a handful of case studies. We highlight that leptospirosis should be considered as a differential diagnosis in those with fever, and new pancytopaenia, particularly in patients with relevant risk factors for exposure.<\/jats:p>","DOI":"10.1136\/bcr-2022-251506","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T10:35:11Z","timestamp":1672914911000},"page":"e251506","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Case of leptospirosis causing pancytopenia"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6372-3781","authenticated-orcid":false,"given":"Ian Satya","family":"Haryono","sequence":"first","affiliation":[{"name":"General Internal Medicine Unit, Western Health, Saint Albans, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0285-9033","authenticated-orcid":false,"given":"Alistair John","family":"Tinson","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5469-4317","authenticated-orcid":false,"given":"Joshua Haron","family":"Abasszade","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Monash Health, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ronan","family":"O\u2019Donnobhain","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Austin Health, Heidelberg, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,1,5]]},"reference":[{"key":"2025082804220514000_16.1.e251506.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00830-2"},{"key":"2025082804220514000_16.1.e251506.2","doi-asserted-by":"crossref","first-page":"105","DOI":"10.31128\/AFP-07-17-4286","article-title":"Leptospirosis: an important zoonosis acquired through work, play and travel","volume":"47","author":"Lau","year":"2018","journal-title":"Aust J Gen Pract"},{"key":"2025082804220514000_16.1.e251506.3","doi-asserted-by":"crossref","unstructured":"Haake DA , Levett PN . Leptospirosis in Humans. In: Adler B , ed. Leptospira and leptospirosis. 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Leptospirosis case definition. Australia Communicable Diseases Network Australia; 2021. https:\/\/www1.health.gov.au\/internet\/main\/publishing.nsf\/Content\/cda-surveil-nndss-casedefs-cd_lepto.htm [Accessed 01 May 2022]."},{"key":"2025082804220514000_16.1.e251506.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2013.09.012"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-251506","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:22:14Z","timestamp":1756380134000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-251506"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,5]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/bcr-2022-251506"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-251506","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}