Delayed psychiatric sequelae following multifocal central nervous system lesions in leptospirosis: A case report.

Ying Liu, Tianyu Zou, Ming Lu, Ping Li, Tianxin Xiang

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Article in IDCases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Ying LiuDepartment of Emergency, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China.

Tianyu ZouJiangxi Provincial Key Laboratory of Respiratory Diseases, Jiangxi Institute of Respiratory Diseases, The Department of Respiratory and Critical Care Medicine, Jiangxi Clinical Research Center for Respiratory Diseases, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China.

Ming LuDepartment of Emergency, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China.

Ping LiDepartment of Emergency, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China.

Tianxin XiangChina-Japan Friendship Jiangxi Hospital, National Regional Center for Respiratory Medicine, Nanchang, Jiangxi 330200, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Leptospirosis is a zoonotic infectious disease that can involve multiple organ systems. Neurological involvement is uncommon, and long-term neuropsychiatric sequelae have rarely been described. We report the case of a previously healthy adult who developed acute leptospiral infection complicated by multifocal central nervous system (CNS) lesions. The patient presented with fever, convulsions, altered mental status. Chest computed tomography (CT) scan revealed diffuse ground-glass opacities and patchy consolidations in both lungs. Brain magnetic resonance (MRI) demonstrated multifocal CNS lesions. Cerebrospinal fluid Metagenomic Next-generation Sequencing (mNGS) confirmed leptospiral infection. The patient received appropriate antimicrobial therapy and recovered fully, with follow-up imaging showing resolution of cortical lesions. Three years later, the patient developed new-onset psychiatric symptoms, including delusions, hallucinations, or personality changes, without evidence of recurrent infection or other organic causes. This case highlights that leptospiral infection may cause multifocal CNS lesions and lead to delayed psychiatric sequelae years after apparent recovery.

Indexed as

Case reportLeptospirosisMultifocal central nervous system lesionsNeuroinfection

Identifiers

PMID41399416

DOI10.1016/j.idcr.2025.e02435

PMCPMC12702039

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