Water leads ID fellows toward publication

Sammantha Kouba, DO, recent Infectious Disease fellowship graduate, and Takaaki Kobayashi, MD, current F3 ID fellow, published a leptospirosis case study in BMJ Case Reports, with patient consent. The publication, with contributions from faculty members Robert Blount, MD, and Loreen Herwaldt, MD, addressed the rare cardiovascular impacts of leptospirosis. 

Kouba and Kobayashi’s report details a 50-year-old man who experienced fever, headaches, body aches, dizziness, and chills following a fall near a water reservoir in Vietnam. He used the water and dew to clean his open wounds. Later he developed an atrial flutter. The man was diagnosed with leptospirosis, a zoonotic blood infection transmitted through contact with contaminated water.

“This case was an important reminder that although we don’t see these types of conditions frequently, the basics of taking an in-depth exposure history can make all the difference in getting the proper diagnosis without delay,” Kouba said. “We actually started treating this patient empirically for leptospirosis, given our high index of suspicion and the fact that the tests can take days to come back, delaying proper therapy.”

Leptospirosis, also known as Weil’s disease, is rare in the United States, affecting only 1,000 Americans each year. In some cases, such as this patient’s, leptospirosis can affect cardiac function. This patient successfully completed cardioversion to slow his heart rate.

This is not Kobayashi’s first published case study in BMJ Case Reports. Last year, Kobayashi published a case of Mycobacterium marinuman infection usually resulting from exposure to contaminated fish tank water.
Although Kobayashi is soon to complete his fellowship, Kouba has already taken a position as an ID specialist with Sanford Health in Fargo, North Dakota. She is grateful for her experience at Iowa. “The UIHC Infectious Disease Fellowship provides its fellows with an endless opportunity for learning in clinical care, scholarly work, and mentorship with the breadth of cases we see, and the quality of the teaching within the department,” Kouba said. “I am so thankful that I can always say I received my ID training at Iowa. I will always treasure my time there.”

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