{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:29:29Z","timestamp":1780471769973,"version":"3.54.1"},"reference-count":17,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of the Royal College of Physicians of Edinburgh"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Leptospirosis is a zoonotic infection occurring worldwide but endemic in tropical countries. This study describes diagnostic testing for leptospirosis at our institution in Scotland over a 10-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We identified patients with blood samples referred to the Public Health England reference laboratory for leptospirosis testing between 2006 and 2016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 480 samples were sent for IgM ELISA testing with 26 positive results from 14 patients. Two patients met criteria for \u2018confirmed\u2019 leptospirosis (microscopic agglutination test &gt; 1:320 in one case and a positive PCR in the other) and the remaining 12 were \u2018probable\u2019 on the basis of IgM ELISA positivity, though 9 did not have microscopic agglutination testing performed. Nine infections were imported, mostly from Asia and with a history of fresh water exposure. Three co-infections (respiratory syncytial virus, influenza B and Campylobacter sp.) were identified.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Practical issues with microscopic agglutination testing (insufficient blood sent to reference laboratory) and PCR (travellers returning &gt; 7 days after illness onset) represent challenges to the laboratory confirmation of a clinical diagnosis of leptospirosis. Co-infection and infectious\/auto-immune causes of false positive serology should be evaluated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4997\/jrcpe.2018.102","type":"journal-article","created":{"date-parts":[[2018,5,14]],"date-time":"2018-05-14T05:43:16Z","timestamp":1526276596000},"page":"9-15","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Challenges in the Diagnosis of Leptospirosis Outwith Endemic Settings: A Scottish Single Centre Experience"],"prefix":"10.1177","volume":"48","author":[{"given":"CD","family":"Russell","sequence":"first","affiliation":[{"name":"Infectious Diseases and Medical Microbiology, Western General Hospital, Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ME","family":"Jones","sequence":"additional","affiliation":[{"name":"Spire Shawfair Park Hospital, Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DT","family":"O'Shea","sequence":"additional","affiliation":[{"name":"Regional Infectious Diseases Unit, Western General Hospital, Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KJ","family":"Simpson","sequence":"additional","affiliation":[{"name":"Department of Hepatology, Royal Infirmary of Edinburgh, Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, Royal Infirmary of Edinburgh, Edinburgh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"IF","family":"Laurenson","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, Royal Infirmary of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,3,1]]},"reference":[{"key":"bibr1-jrcpe.2018.102","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00830-2"},{"key":"bibr2-jrcpe.2018.102","doi-asserted-by":"publisher","DOI":"10.1016\/S1286-4579(00)01280-6"},{"key":"bibr3-jrcpe.2018.102","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-016-1349-x"},{"key":"bibr4-jrcpe.2018.102","doi-asserted-by":"publisher","DOI":"10.1086\/313501"},{"key":"bibr5-jrcpe.2018.102","unstructured":"Public Health England. 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