{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T17:40:05Z","timestamp":1722447605785},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,1,10]]},"abstract":"<jats:p>Leptospirosis is an emerging bacterial zoonosis that is endemic but underrecognized throughout the tropics. Through prospective surveillance for acute febrile illness (AFI) among patients who presented to the emergency department of a hospital located in an urban region of Puerto Rico, four patients with laboratory-confirmed leptospirosis were identified. All patients had signs and symptoms of AFI, including fever, headache, and dehydration. Three patients had leukocytosis with thrombocytopenia and were admitted to the hospital. One hospitalized patient presented with jaundice, icteric sclera, and hematuria and developed rhabdomyolysis, whereas another patient with pulmonary edema was admitted to the intensive care unit. Microscopic agglutination titers among the four patients were highest against serogroups Icterohaemorrhagiae (serovar Mankarso), Australis (serovar Bratislava), Bataviae (serovar Bataviae), and Canicola (serovar Canicola). These case reports demonstrate that infection with these apparently uncommon serogroups can result in illness ranging from mild to life-threatening.<\/jats:p>","DOI":"10.4269\/ajtmh.17-0538","type":"journal-article","created":{"date-parts":[[2017,11,17]],"date-time":"2017-11-17T10:17:58Z","timestamp":1510913878000},"page":"258-261","source":"Crossref","is-referenced-by-count":5,"title":["Leptospirosis Cases Infected with Uncommon Serogroups, Puerto Rico, 2013\u20132015"],"prefix":"10.4269","volume":"98","author":[{"given":"Hector","family":"Gorbea","sequence":"first","affiliation":[{"name":"University of Puerto Rico School of Medicine, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enid J.","family":"Garcia-Rivera","sequence":"additional","affiliation":[{"name":"University of Puerto Rico School of Medicine, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilda","family":"Torres","sequence":"additional","affiliation":[{"name":"University of Puerto Rico School of Medicine, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga D.","family":"Lorenzi","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aidsa","family":"Rivera","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renee L.","family":"Galloway","sequence":"additional","affiliation":[{"name":"Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler M.","family":"Sharp","sequence":"additional","affiliation":[{"name":"Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, San Juan, Puerto Rico;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Infect Dis","first-page":"757","article-title":"Leptospirosis: a zoonotic disease of global importance","volume":"3","author":"Bharti","year":"2003"},{"key":"b2","series-title":"Clin Microbiol Rev","first-page":"296","article-title":"Leptospirosis","volume":"14","author":"Levett","year":"2001"},{"key":"b3","series-title":"PLoS Negl Trop Dis","first-page":"e0003898","article-title":"Global morbidity and mortality of leptospirosis: a systematic review","volume":"9","author":"Costa","year":"2015"},{"key":"b4","series-title":"PLoS Negl Trop Dis","first-page":"e0004122","article-title":"Global burden of leptospirosis: estimated 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