Host biomarkers distinguish dengue from leptospirosis in Colombia: a case-control study

BMC Infect Dis. 2014 Jan 20;14:35. doi: 10.1186/1471-2334-14-35.

Abstract

Background: Dengue fever and leptospirosis have partially overlapping geographic distributions, similar clinical presentations and potentially life-threatening complications but require different treatments. Distinguishing between these cosmopolitan emerging pathogens represents a diagnostic dilemma of global importance. We hypothesized that perturbations in host biomarkers can differentiate between individuals with dengue fever and leptospirosis during the acute phase of illness.

Methods: We randomly selected subjects from a prospective cohort study of acute febrile illness in Bucaramanga, Colombia and tested 19 serum biomarkers by ELISA in dengue fever (DF, n = 113) compared to subjects with leptospirosis (n = 47). Biomarkers were selected for further analysis if they had good discriminatory ability (area under the ROC curve (AUC) >0.80) and were beyond a reference range (assessed using local healthy controls).

Results: Nine biomarkers differed significantly between dengue fever and leptospirosis, with higher levels of Angptl3, IL-18BP, IP-10/CXCL10, Platelet Factor 4, sICAM-1, Factor D, sEng and sKDR in dengue and higher levels of sTie-2 in leptospirosis (p < 0.001 for all comparisons). Two biomarkers, sEng and IL18BP, showed excellent discriminatory ability (AUROC >0.90). When incorporated into multivariable models, sEng and IL18BP improved the diagnostic accuracy of clinical information alone.

Conclusions: These results suggest that host biomarkers may have utility in differentiating between dengue and leptospirosis, clinically similar conditions of different etiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cohort Studies
  • Colombia
  • Dengue / blood
  • Dengue / diagnosis*
  • Diagnosis, Differential
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Host-Pathogen Interactions
  • Humans
  • Leptospirosis / blood
  • Leptospirosis / diagnosis*
  • Male
  • Middle Aged
  • Prospective Studies
  • Young Adult

Substances

  • Biomarkers