{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:34:49Z","timestamp":1792132489875,"version":"4.4.0"},"reference-count":17,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,8,5]]},"abstract":"<jats:p>Leptospirosis is a potentially severe illness in returned travelers. Patients often present with fever, headache, and neck pain, which may lead to a workup for meningitis including the acquisition of cerebrospinal fluid (CSF). Although <jats:italic>Leptospira<\/jats:italic> DNA has been detected in CSF by polymerase chain reaction (PCR), little data exist regarding the utility of testing CSF in addition to serum or plasma obtained on presentation. In this report, we present two cases of leptospirosis in returned travelers presenting with fever and headache. Our first patient had neutrophilic meningitis, and <jats:italic>Leptospira<\/jats:italic> was detectable only in CSF obtained on admission. The second patient had a normal CSF profile, but <jats:italic>Leptospira<\/jats:italic> was detected in CSF at a bacterial load 5- to 10-fold higher than that in plasma. CSF is an important specimen for the diagnosis of <jats:italic>Leptospira<\/jats:italic> by molecular methods and may yield an actionable diagnosis in the absence of leptospiremia.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0174","type":"journal-article","created":{"date-parts":[[2015,6,2]],"date-time":"2015-06-02T13:47:01Z","timestamp":1433252821000},"page":"238-240","source":"Crossref","is-referenced-by-count":13,"title":["Molecular Detection of Leptospira in Two Returned Travelers: Higher Bacterial Load in Cerebrospinal Fluid Versus Serum or Plasma"],"prefix":"10.4269","volume":"93","author":[{"given":"Jesse J.","family":"Waggoner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth 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Cruz","first-page":"988","article-title":"Aseptic meningitis caused by Leptospira spp diagnosed by polymerase chain reaction","volume":"105","author":"Romero","year":"2010"},{"key":"ref13","series-title":"Ann Intern Med","first-page":"794","article-title":"Sporadic urban leptospirosis","volume":"125","author":"Vinetz","year":"1996"},{"key":"ref14","series-title":"J Clin Microbiol","first-page":"2011","article-title":"Multiplex nucleic acid amplification test for the diagnosis of dengue, malaria, and leptospirosis","volume":"52","author":"Waggoner","year":"2014"},{"key":"ref15","series-title":"PLoS One","first-page":"e112356","article-title":"Sensitive real-time PCR detection of pathogenic Leptospira spp. and a comparison of nucleic acid amplification methods for the diagnosis of leptospirosis","volume":"9","author":"Waggoner","year":"2014"},{"key":"ref16","series-title":"N Engl J Med","first-page":"2408","article-title":"Actionable diagnosis of neuroleptospirosis by next-generation sequencing","volume":"370","author":"Wilson","year":"2014"},{"key":"ref17","series-title":"PLoS One","first-page":"e16236","article-title":"Diagnostic accuracy of real-time PCR assays targeting 16S rRNA and lipL32 genes for human leptospirosis in Thailand: a case-control study","volume":"6","author":"Thaipadungpanit","year":"2011"}],"container-title":["The American Society of Tropical Medicine and 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