Nokea
A 33 year old patient was delivered to the infectious diseases department on the 7-th day of disease. He complained about great weakness, high temperature, pain in the lumbar area and leg muscles, icteritiousness, dark color of urine, headache. The acute disease started with chill, body temperature rise up to 40oC, headache, pain in the lumbar area and sural muscles. Icterus turned up on the 4th day, nasal and scleral haemorrhages came on the 5th day. Fever has lasted for 6 days. Diuresis - 200 ml. What is the most probable diagnosis?
Correct Answer: A
Rationale: The most probable diagnosis is Leptospirosis. The symptoms described align with the classic presentation of Leptospirosis, such as fever, muscle pain, headache, jaundice, and hemorrhages. The initial symptoms of chills, high fever, and muscle pain followed by jaundice and hemorrhages are characteristic of Leptospirosis. The presence of dark urine and low diuresis also point towards kidney involvement, which is common in Leptospirosis due to renal failure. Additionally, the patient's history of potential exposure to contaminated water or soil supports the diagnosis, as Leptospirosis is commonly transmitted through contact with infected animal urine.
Summary of other choices:
- Typhoid fever typically presents with sustained fever, abdominal pain, and constipation, not matching the symptoms described.
- Virus A hepatitis usually presents with jaundice, but other symptoms such as muscle pain and hemorrhages are not typical.
- Sepsis is a systemic response