Prospective case-control analysis of the aetiologies of acute undifferentiated fever in Vietnam

Le-Viet, Nhiem; Le, Viet-Nho; Chung, Hai; Phan, Duc-Tuan; Phan, Quang-Duong; Cao, Thanh-Van; Abat, Cédric; Raoult, Didier; Parola, Philippe

Leptospirosis is one of the most common zoonotic diseases worldwide, and this potentially fatal disease is considered a public health issue in Asia [3, 9] . This infection is also known as an important cause of fever in returning travellers [31] . Despite its high seroprevalence in humans and animals in Vietnam, very few cases have been documented [32] . We detected Leptospira DNA in 4.8% of AUFs and 0.8% of Controls. During this study, the clinicians never suspected any cases of leptospirosis among the 18 cases with confirmed leptospirosis, but they suspected that three of these cases were scrub typhus and prescribed doxycycline. These patients presented a medium febrile course, and two-thirds of these patients had a headache. Other basic laboratory results, such as the WBC count, PLT count and serum aminotransaminase levels, were normal, which did not aid the diagnosis of the disease. Thus, clinicians may, in such cases, diagnose leptospirosis, but they must nevertheless pay particular attention to the illness process in these patients and the exclusion of other causes.