{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:01:58Z","timestamp":1757610118015,"version":"3.44.0"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Leptospirosis a significant and life-threatening zoonosis with global reach. If diagnosis and treatment are delayed, the infection may lead to fatal Weil\u2019s disease. In the Philippines, a 21-year-old man was admitted to the hospital with leptospirosis-like symptoms, including fever, myalgia, headache, anuria, jaundice, hemorrhage, skin rash, and diarrhea. Although he was immediately treated with penicillin G, the patient died shortly after admission. The serological test result was negative for <jats:italic>Leptospira<\/jats:italic>; however, three leptospires were isolated from the patient through selective cultivation under varying conditions. Microscopic agglutination tests and a phylogenetic analysis of the <jats:italic>flaB<\/jats:italic> gene encoding the flagellin subunit protein revealed that the isolates belonged to three different serovars, suggesting that the patient was simultaneously infected with at least three distinct <jats:italic>Leptospira<\/jats:italic> serovars. In this case report, we highlight the potential risk of multiple infections with leptospires in humans, a critical consideration for diagnosis and treatment strategies.<\/jats:p>","DOI":"10.4269\/ajtmh.24-0403","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T12:04:51Z","timestamp":1751371491000},"page":"674-677","source":"Crossref","is-referenced-by-count":0,"title":["A Case of Infection with Leptospires from Three Different Serovars During a Flood in the Philippines"],"prefix":"10.4269","volume":"113","author":[{"given":"Yasutake","family":"Yanagihara","sequence":"first","affiliation":[{"name":"Department of Immunology and Microbiology, School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan;"},{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiyuki","family":"Masuzawa","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology and Immunology, Faculty of Pharmaceutical Sciences, Chiba Institute of Science, Chiba, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masashi","family":"Shingai","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Japan;"},{"name":"International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Division of Vaccine Immunology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marumi","family":"Ohno","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Japan;"},{"name":"One Health Research Center, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshiki","family":"Sekiya","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Japan;"},{"name":"International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Nomura","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Japan;"},{"name":"Division of International Research Promotion, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomomi","family":"Kawakita","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Japan;"},{"name":"Division of Vaccine Immunology, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chimuka","family":"Handabile","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Koshiishi","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Obeng-Kyeremeh","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiro","family":"Ito","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsumasa","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Microbiology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon Y. A. M.","family":"Villanueva","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, College of Public Health, University of the Philippines Manila, Philippines;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina G.","family":"Gloriani","sequence":"additional","affiliation":[{"name":"Institute of Pathology, St. Luke\u2019s Medical Center, Quezon City, Philippines"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Kida","sequence":"additional","affiliation":[{"name":"Division of Biologics Development, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Institute for Vaccine Research and Development, Hokkaido University, Sapporo, Japan;"},{"name":"International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo, Japan;"},{"name":"Division of Vaccine Immunology, International Institute for Zoonosis Control, Hokkaido University, 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