{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T03:42:23Z","timestamp":1776397343304,"version":"3.51.2"},"reference-count":18,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Leptospirosis is typically a self-limited febrile illness; when it occurs, meningitis usually develops early in the course. Here, we describe a patient who had engaged in freshwater activities in Kauai that was immunocompromised due to a history of mantle cell lymphoma, autologous hematopoietic cell transplant, and hypogammaglobulinemia. He developed leptospiral meningoencephalitis 11\u2009weeks after illness onset and persistently detectable <jats:italic>Leptospira<\/jats:italic> DNA in blood and cerebrospinal fluid along with ongoing clinical illness, despite appropriate treatment.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0111","type":"journal-article","created":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T14:57:36Z","timestamp":1692629856000},"page":"730-732","source":"Crossref","is-referenced-by-count":3,"title":["Case Report: Relapsing Leptospirosis in an Immunocompromised Host"],"prefix":"10.4269","volume":"109","author":[{"given":"Ritika","family":"Prasad","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niyati K.","family":"Narsana","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Davis School of Medicine, University of California, Sacramento, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonette A.","family":"Ajayi","sequence":"additional","affiliation":[{"name":"Critical Care Medicine and Pulmonary Disease, Montage Health, Monterey, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayna","family":"Patel","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Medicine, Stanford Health Care, Stanford, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dora Y.","family":"Ho","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niaz","family":"Banaei","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California;"},{"name":"Department of Pathology, Stanford University School of Medicine, Stanford, California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian G.","family":"Blackburn","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Postgrad Med J","first-page":"589","article-title":"Primary neuroleptospirosis","volume":"77","author":"Panicker","year":"2001"},{"key":"b2","series-title":"Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases","author":"Haake"},{"key":"b3","series-title":"Clin Microbiol Rev","first-page":"296","article-title":"Leptospirosis","volume":"14","author":"Levett","year":"2001"},{"key":"b4","series-title":"Near-fatal Legionella pneumonia in a neonate linked to home humidifier by metagenomic next generation sequencing. Med","first-page":"565","volume":"12","author":"West","year":"2022"},{"key":"b5","series-title":"Clin Infect Dis","first-page":"1249","article-title":"Utility of quantitative polymerase chain reaction in leptospirosis diagnosis: association of level of leptospiremia and clinical manifestations in Sri Lanka","volume":"54","author":"Agampodi","year":"2012"},{"key":"b6","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":"b7","series-title":"Diagn Microbiol Infect Dis","first-page":"1","article-title":"Rapid tests for diagnosis of leptospirosis: current tools and emerging technologies","volume":"78","author":"Picardeau","year":"2014"},{"key":"b8","series-title":"BMJ","first-page":"231","article-title":"Leptospirosis","volume":"1","author":"Turner","year":"1969"},{"key":"b9","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":"b10","series-title":"BMJ","first-page":"7","article-title":"Chronic meningitis in Weil\u2019s disease","volume":"1","author":"Murgatroyd","year":"1937"},{"key":"b11","series-title":"J Clin Microbiol","first-page":"1894","article-title":"Detection of leptospires in urine by PCR for early diagnosis of leptospirosis","volume":"32","author":"Bal","year":"1994"},{"key":"b12","series-title":"Kidney Int","first-page":"918","article-title":"Leptospirosis renal disease: understanding the initiation by Toll-like receptors","volume":"72","author":"Yang","year":"2007"},{"key":"b13","series-title":"South Med J","first-page":"405","article-title":"Long-term follow-up after leptospirosis","volume":"83","author":"Shpilberg","year":"1990"},{"key":"b14","series-title":"Scand J Immunol","first-page":"408","article-title":"Leptospirosis: aspects of innate immunity, immunopathogenesis and immune evasion from the complement system","volume":"73","author":"Fraga","year":"2011"},{"key":"b15","series-title":"Br J Haematol","first-page":"3","article-title":"The effect of rituximab on humoral and cell mediated immunity and infection in the treatment of autoimmune diseases","volume":"149","author":"Cooper","year":"2010"},{"key":"b16","series-title":"Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis","author":"Styka","year":"2020"},{"key":"b17","year":"2019"},{"key":"b18","year":"2023"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/109\/4\/article-p730.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/109\/4\/article-p730.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/109\/4\/article-p730.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T12:35:07Z","timestamp":1696422907000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/109\/4\/article-p730.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,4]]},"references-count":18,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.23-0111","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,4]]}}}