08 July 2025
: Case report 
Distinguishing Jarisch-Herxheimer Reaction From Septic Shock in Leptospirosis Patients: A Case Study
Challenging differential diagnosis, Unusual setting of medical care
Koma Hotta
E 1*, Takahiro Maruyama E 1, Takamasa Ito E 2, Takahiro Yonemoto E 2, Shunsuke Kasai E 2, Haruki Imura E 2
DOI: 10.12659/AJCR.947704
Am J Case Rep 2025; 26:e947704
Table 1 Laboratory data results.
| Test parameter (units) | Measured value | Reference range |
|---|---|---|
| White-cell count (/μL) | 12 800 | 4000–9000 |
| Hemoglobin (g/dL) | 11.9 | 12.0–16.5 |
| Hematocrit (%) | 34.4 | 35.0–45.0 |
| Mean corpuscular volume (fL) | 93.0 | 85–100 |
| Platelet (/μL) | 145 000 | 150 000–350 000 |
| Total protein (g/dL) | 5.4 | 6.7–8.3 |
| Albumin (g/dL) | 2.7 | 4.0–5.0 |
| Total bilirubin (mg/dL) | 1.0 | 0.3–1.2 |
| Aspartate aminotransferase (U/L) | 129 | 13–33 |
| Alanine aminotransferase (U/L) | 127 | 6–27 |
| γ-glutamyl transpeptidase (U/L) | 197 | 10–47 |
| Lactate dehydrogenase (U/L) | 296 | 119–229 |
| Creatine kinase (U/L) | 72 | 45–163 |
| Urea nitrogen (mg/dL) | 23.0 | 8.0–22.0 |
| Creatinine (mg/dL) | 1.21 | 0.40–0.70 |
| Sodium (mEq/L) | 135 | 138–146 |
| Potassium (mEq/L) | 4.0 | 3.6–4.9 |
| Chloride (mEq/L) | 105 | 99–109 |
| C-reactive protein (mg/dL) | 12.16 | <0.3 |