A CASE OF LEPTOSPIROSIS WITH ERYTHEMA NODOSUM AND REACTIVE ARTHRITIS DURING THE FIRST TRIMESTER OF PREGNANCY

Abstract

Leptospirosis is a zoonosis and occurs in endemic as well as epidemic forms in many parts of India. Manifestations may range from asymptomatic infection to fulminant fatal disease with myositis, conjunctivitis, hepatic, renal, cardiac and neurological involvement and hemorrhagic manifestations. A 30 years old lady in her first trimester of gestation presented with fever, multiple painful erythematous swellings over the front of both legs and swelling associated with pain of left ankle joint for 1 week . On evaluation she had erythema nodosum over the anterior aspect of both lower extremities and reactive arthritis of left ankle joint. Leptospira serology for Immunoglobulin M was positive. She was started on intravenous ceftriaxone 1 gm twice daily. After 7 days of treatment, erythema nodosum and reactive arthritis subsided. Erythema nodsum and reactive arthritis which are rare manifestations of leptospirosis have occurred together in a patient during the first trimester of pregnancy makes this case worth presenting.