Colorectal problem in leptospirosis

Dear, Editor, leptospirosis is an important zoonotic leptospiral infection. This infection is common and endemic in several tropical countries. The patients with leptospirosis usually have high fever and other systematic clinical problems such as renal failure and jaundice. The colorectal manifestation of leptospirosis is possible but little mentioned. Sometimes, the colorectal presentation of leptospirosis might be missed or incorrectly diagnosed. The good example is the missed diagnosis of leptospirosis as colon cancer [1]. Colon ulcer might be detected by colonoscopy study [1]. The pathogenesis is according to colonic spirochetosis pathological process. Direct colonic involvement might be shown by histological study. Indeed, the gastrointestinal symptoms including diarrhea is observable in cases with leptospirosis [2]. The patient might also have severe abdominal pain [2]. In severe case, abdominal CT scan might reveal pancolitis [3]. In fact, colon might be an affected organ in leptospirosis. In rare case, ischemia of colon is observable [4 - 5]. In any case with atypical clinical problem, colorectal manifestation might be a clinical feature of leptospirosis. The practitioner should recognize and consider this problem in any case from or having history of visiting to tropical endemic area.