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Laboratory testing showed severe thrombocytopenia and coagulopathy consistent with disseminated intravascular coagulation, alongside hepatic and mild renal dysfunction. Broad infectious evaluation for dengue, hepatitis, HIV, malaria, syphilis, yellow fever, and other sources was negative. Convalescent-phase serum demonstrated anti-Leptospira IgM seroconversion, confirming leptospirosis.",{"@graph":69,"@context":127},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-case-of-disseminated-intravascular-coagulation-by-leptospirosis-during-the-ongoing-yellow-fever-outbreak-in-colombia-letter-to-the-editor/432900/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-case-of-disseminated-intravascular-coagulation-by-leptospirosis-during-the-ongoing-yellow-fever-outbreak-in-colombia-letter-to-the-editor/432900.png","ImageObject",300,407,{"name":92,"@type":93},"Rainbow Cat","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-03","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",11,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119,123],{"name":110,"@type":111,"acceptedAnswer":112},"What clinical features indicated disseminated intravascular coagulation in this patient?","Question",{"text":113,"@type":114},"Severe thrombocytopenia with prolonged prothrombin time/INR and elevated D-dimer, meeting ISTH criteria for disseminated intravascular coagulation.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"How was leptospirosis diagnosed despite negative initial infectious tests?",{"text":118,"@type":114},"Initial testing for leptospira was negative, but a convalescent-phase paired serum sample showed anti-Leptospira IgM seroconversion by ELISA, confirming leptospirosis.",{"name":120,"@type":111,"acceptedAnswer":121},"What factors supported considering yellow fever and dengue in the differential diagnosis?",{"text":122,"@type":114},"The patient was in an area with an ongoing yellow fever outbreak, and her fever and systemic findings initially raised suspicion for arboviral infections; targeted RT-PCR and dengue NS1 testing were then used.",{"name":124,"@type":111,"acceptedAnswer":125},"What treatment led to recovery and what was the outcome?",{"text":126,"@type":114},"Empirical antibiotics with vancomycin and ceftriaxone plus vasopressor support were provided for 7 days; the patient improved without transfusion and was discharged on April 7, 2025 with full symptom resolution.","https://schema.org",{"og:url":83,"og:type":129,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":131,"canonical":83},"index,follow",{"doc_id":133,"site_id":62},432900,1790854127,{"code":4,"msg":5,"data":136},{"doc_id":133,"user_id":137,"nickname":92,"user_avatar":138,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":139,"file_id":140,"file_url":141,"file_type":142,"file_size":143,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":144,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":145,"faqs":146,"seo_title":147,"seo_description":67,"update_tm":148,"read_time":24,"preview_page_count":4},962090769181,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","New Microbes and New Infections 69 (2026) 101684  \nContents lists available at ScienceDirect  \nNew Microbes and New Infections  \njournal [homepage:](homepage: www.journals.elsevier.com/new-microbes-and-new-infections)[ www.journals.elsevier.com/new-microbes-and-new-infections](homepage: www.journals.elsevier.com/new-microbes-and-new-infections)  \nLetter to the Editor  \nA case of disseminated intravascular coagulation by leptospirosis during the ongoing yellow fever outbreak in Colombia  \nA R T I C L E I N F O  \nKeywords:  \nDisseminated intravascular coagulation Leptospirosis  \nTropical medicine  \nFever  \nColombia  \nDear Editor,  \nOn March 28, 2025, a 19-year-old female professional soldier, with no relevant past medical history, stationed in San Jos´e del Guaviare (Colombian Amazon region) for the preceding three months, was admitted to our institution, Hospital Militar Central, in Bogot´a, Colombia. She presented a one-day history of high-grade fever (40 ◦ C) and a generalized tonic-clonic seizure, accompanied by loss of sphincter control and requirement for invasive mechanical ventilation. Notably, she had received yellow fever vaccine 14 days prior to symptom onset.  \nOn physical examination, conjunctival suffusion and subconjunctival hemorrhage were observed (Fig. 1); the remainder physical examination was unremarkable. Laboratory evaluation revealed severe thrombocytopenia without anemia or leukopenia, elevated hepatic transaminases, mild renal dysfunction, prolonged prothrombin time, elevated INR, and increased D-dimer levels (Table 1), findings consistent with Disseminated intravascular coagulation (DIC) (ISTH Score = 7).  \nAcute-phase serum sample tested negative for dengue virus (NS1 antigen and IgM, by VIDAS® Assay), Leptospira spp. (IgM by ELISA), hepatitis A, B, and C viruses, and HIV. Additionally, thick blood smear for malaria, VDRL for syphilis, and RT-PCR for yellow fever virus were negative. Cerebrospinal fluid analysis revealed no abnormalities, with no pleocytosis, no elevated protein levels, and normal glucose concentration. Blood cultures were also negative. Imaging studies, including brain MRI, chest radiography, and abdominal ultrasound, were unremarkable.  \nThe patient received empirical antibiotic therapy with vancomycin and ceftriaxone for 7 days, along with vasopressor support. Her clinical course was favorable, with no requirement for transfusion of blood products, fresh frozen plasma, or cryoprecipitate. The patient was discharged on April 7, 2025. A convalescent-phase paired serum sample, collected on April 28, 2025, tested positive for anti-Leptospira IgM by ELISA (value: 12.71; positive index value > 11), confirming the diagnosis of leptospirosis by seroconversion.  \nDisseminated intravascular coagulation is an infrequent but potentially life-threatening complication recognized in tropical infectious diseases such as leptospirosis and yellow fever [1,2]. We report a case of  \na previously healthy young woman who was admitted with high-grade fever, generalized tonic-clonic seizures, altered mental status, thrombocytopenia, coagulopathy, hepatic dysfunction, and elevated inflammatory markers. In the setting of an ongoing yellow fever outbreak, these clinical features initially raised strong suspicion of this arboviral infection [2,3]. In our patient, given the epidemiological context, diagnostic workup included RT-PCR for yellow fever, RT-PCR and NS1 antigen for dengue, and thick blood smear for malaria, all of which yielded negative results. IgM seroconversion against Leptospira in a convalescent-phase serum sample confirmed the diagnosis, consistent with the expected serologic kinetics of this infection [1]. Early initiation of ceftriaxone led to a favorable clinical course, with full resolution of symptoms and recovery without sequelae.  \nLeptospirosis is a zoonotic disease with a broad clinical spectrum, ranging from mild febrile illness to severe manifestations such as Weil’s disease, charact","cbCaiq4XIbxFgk73","https://ap.wps.com/l/cbCaiq4XIbxFgk73","pdf",679356,"English","# Letter to the Editor\n## Case presentation and diagnostic workup\n## Treatment and clinical outcome\n## Discussion of pathophysiology and implications","[{\"question\":\"What clinical features indicated disseminated intravascular coagulation in this patient?\",\"answer\":\"Severe thrombocytopenia with prolonged prothrombin time/INR and elevated D-dimer, meeting ISTH criteria for disseminated intravascular coagulation.\"},{\"question\":\"How was leptospirosis diagnosed despite negative initial infectious tests?\",\"answer\":\"Initial testing for leptospira was negative, but a convalescent-phase paired serum sample showed anti-Leptospira IgM seroconversion by ELISA, confirming leptospirosis.\"},{\"question\":\"What factors supported considering yellow fever and dengue in the differential diagnosis?\",\"answer\":\"The patient was in an area with an ongoing yellow fever outbreak, and her fever and systemic findings initially raised suspicion for arboviral infections; targeted RT-PCR and dengue NS1 testing were then used.\"},{\"question\":\"What treatment led to recovery and what was the outcome?\",\"answer\":\"Empirical antibiotics with vancomycin and ceftriaxone plus vasopressor support were provided for 7 days; the patient improved without transfusion and was discharged on April 7, 2025 with full symptom resolution.\"}]","A case of disseminated intravascular coagulation by leptospirosis during the ongoing yellow fever outbreak in Colombia - Letter to the Editor | PDF",1790661830]