{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T23:57:29Z","timestamp":1781049449984,"version":"3.54.1"},"reference-count":0,"publisher":"Pasifika Medical Association Group","issue":"1636","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NZMJ"],"abstract":"<jats:p>aim: Leptospirosis is a bacterial zoonosis often under-diagnosed due to its presentation as an undifferentiated febrile illness. This study\naimed to explore the clinical complexities involved in diagnosing and managing leptospirosis cases in New Zealand.\nmethod: Qualitative content analysis of clinical notes from 42 leptospirosis cases used a dual deductive and inductive approach to\nidentify key themes.\nresults: Three key themes emerged, highlighting the critical role of clinician reasoning in early detection and appropriate clinical\nresponse: 1) multiple factors contribute to delayed diagnosis, including incomplete exposure histories and deviation of symptoms\nfrom textbook definitions, 2) there were challenges with diagnosis and the use of medication in post-acute care, and 3) interpretation\nand use of confirmatory tests was inconsistent and complex. Clinicians were confident in suspecting leptospirosis when clinical\nhistory taking also assessed relevant exposure.\nconclusion: Based on these findings, we have made recommendations to prevent delayed diagnosis. We advocate updating\nclinical references to better reflect New Zealand\u2013specific disease presentation and risk factors to support early diagnosis. National\nstandardisation of diagnostic test timing, selection and interpretation is recommended, alongside clearer notification pathways.\nFurther research could focus on early diagnostic markers to improve clinical decision making in practice.<\/jats:p>","DOI":"10.26635\/6965.7200","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T23:05:51Z","timestamp":1781046351000},"page":"76-86","source":"Crossref","is-referenced-by-count":0,"title":["Clinical complexities in diagnosing and managing leptospirosis in New Zealand: a qualitative analysis"],"prefix":"10.26635","volume":"139","author":[{"given":"Tanya","family":"Quin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahista","family":"Nisa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Benschop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Prinsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Polly","family":"Yeung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Collins-Emerson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11177","published-online":{"date-parts":[[2026,6,12]]},"container-title":["New Zealand Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T23:05:53Z","timestamp":1781046353000},"score":1,"resource":{"primary":{"URL":"https:\/\/nzmj.org.nz\/journal\/vol-139-no-1636\/clinical-complexities-in-diagnosing-and-managing-leptospirosis-in-new-zealand-a-qualitative-analysis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,12]]},"references-count":0,"journal-issue":{"issue":"1636","published-online":{"date-parts":[[2026,6,12]]}},"URL":"https:\/\/doi.org\/10.26635\/6965.7200","relation":{},"ISSN":["1175-8716"],"issn-type":[{"value":"1175-8716","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,12]]}}}