Hemorrhagic fever with renal syndrome and leptospirosis: Differential diagnosis

Abstract

   Hemorrhagic fever with renal syndrome and leptospirosis have similarities and differences in the clinical picture. Fever, intoxication, pronounced kidney damage and hemorrhagic syndrome are observed in both infections. The course of these diseases may be complicated by the development of infectious-toxic shock, acute renal failure, disseminated intravascular coagulation. Clinical manifestations of the syndrome of jaundice and meningitis may be observed in leptospirosis, but are not characteristic of hemorrhagic fever with renal syndrome. In leptospirosis, in contrast to hemorrhagic fever with renal syndrome, liver failure may develop. Infection with these diseases often occurs during a stay in a forest, in a holiday home, in rural areas. The natural foci of these infections may be located on the same territories or border each other, which also complicates the differential diagnostics. The article provides information on the etiology, epidemiology, geographical distribution, pathogenesis, pathological anatomy, clinical picture and diagnostics of hemorrhagic fever with renal syndrome and leptospirosis. Based on these data, the pathophysiological, clinical and laboratory aspects of the differential diagnosis between these diseases are analyzed in detail.