The role of clinical and laboratory finding in the differential diagnosis of hantavirus and leptospirosis infections

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Abstract
Background & objectives: Hantavirus and leptospirosis infections are zoonotic diseases with similar clinical and laboratory findings. The aim of this study is to identify the distinguishing features of these two diseases, for which a definitive diagnosis can take a long time. Methods: Between September 2021 and June 2023, a total of 45 patients who were admitted to our hospital and were diagnosed with hemorrhagic fever with renal syndrome (HFRS) or leptospirosis were retrospectively evaluated. Patients were compared in terms of demographic data, clinical, and laboratory parameters. The role of these variables in predicting HFRS or leptospirosis was investigated. The two diseases were compared with regard to outcomes. Receiver operating characteristics were employed for the calculation of cut-off values, sensitivity, specificity, and positive and negative predictive values for parameters showing significant differences. A statistical significance level of p<0.05 was considered. Results: Fifteen patients diagnosed with HFRS and thirty patients diagnosed with leptospirosis were included in the study. In both groups, hospital admissions were observed with non-specific and similar symptoms. There was no statistically significant difference observed between the two groups in terms of length of hospital stay, blood product transfusion, requirement for hemodialysis, intensive care unit admission, the rate of return to normal renal function and mortality. Elevated ferritin levels were statistically significant in favor of HFRS, while lymphopenia, elevated bilirubin, CRP, and ESR were statistically significant in favor of leptospirosis. Interpretation & conclusion: The use of laboratory findings and clinical symptoms can aid in the challenging task of accurately diagnosing and using appropriate treatment for these two diseases.

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