Leptospirosis in a caver returned from Sarawak, Malaysia.

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Leptospirosis in a caver returned from Sarawak, Malaysia.

Mortimer RB.

Department of Family Practice, University of California, San Francisco,
Fresno Medical Education Program, Fresno, CA 93702, USA.

This article describes a case of leptospirosis in a man who returned
from caving in Sarawak, Malaysia, and includes a discussion of
epidemiology, pathophysiology, diagnosis, prevention, and treatment.
The patient presented with symptoms of leptospirosis, which was
confirmed by microhemagglutination titers. He became infected despite
taking doxycycline daily for malaria prophylaxis. Leptospirosis is an
important consideration in any returned traveler with fever. The
spirochete spreads from animals to humans via water. Caving in tropical
endemic zones may increase exposure risk due to the combination of
multiple skin abrasions with immersions. Water in caves may increase
infection risk because of increased water pH. Standard prophylaxis may
be inadequate in cases of high-risk exposures.

PMID: 16209467

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