I experienced this last year, a week before Ramadan. Now that Ramadan is coming up, I thought of writing this throwback story, on how I suffered after being infected with Leptospirosis (Kencing Tikus). The layman term is “Rat Urine”.
In case you didn’t know, Leptospirosis (or in Bahasa Malaysia, Kencing Tikus) is an infection caused by corkscrew-shaped bacteria called Leptospirosa. The bacteria species is then divided to many other groups but the easiest way to say this is that this bacteria is found in rodents, wild and domestic animals.
What Happened When I Was Infected With Leptospirosis (Kencing Tikus)?
Leptospirosis is a worldwide disease but can be serious public health issue in humid tropical and subtropical country like Malaysia. In Malaysia, Leptospirosis is usually caused by rats and their urine.
It started with fever and body aches. When I first had the fever, I self-medicate with Paracetamol and went about doing my regular work daily.
After about 8 days, I noticed that my fever was always on-and-off and the body aches would come and go as well. I sometimes felt lethargic but I tried to do some body workouts to keep the blood pumping – trying to keep the lethargy out of the way.
At that point, I had to go to another state for a media trip. My fever and body aches was still on-and-off but one day during my media trip, my fever shot high and I started getting the chills.
I told myself that this time I need to go see a doctor but since I was in another state, I tried keeping the fever at bay with more Paracetamol, Kool Fever on my forehead and drinking water with electrolytes before returning home.
The next night after I returned home from the trip – this being 10 days after the first day I had fever – I couldn’t sleep. My body was aching everywhere, I couldn’t sleep or rest well. I was shivering badly but my body was very hot to the touch. I even called my mom (at 3 o’clock in the morning) and asked her to sleep next to me.
By 7 o’clock in the morning, I couldn’t take it anymore. I noticed there were small red spots all over my body and both my corneas (eyes) were red. My body aches and chills were unbearable. My mom decided we should go to the Emergency room straight away.
We head to KPJ Kajang and after the usual checks and measurement, I met with the doctor. At this point, I suspected dengue fever and so did he but to be sure, he sent me off for blood test.
By this time, I just lay down restlessly on one of the bed in the Emergency rooms. I couldn’t find a comfortable position at all, and I felt the cold right down to my bones.
After 20 minutes, the results are in and it wasn’t dengue, it was Leptospirosis (Kencing Tikus).
How Did I Get Infected With Leptospirosis (Kencing Tikus)?
I had no idea where and when I was infected with Leptospirosis (Kencing Tikus).
My doctor asked the usual question, “Have you been playing or been near waterfall, river or the ocean lately?” This is because, there is a higher chance of you being infected at waterfalls, river or ocean due to stagnant water nearby these places that might have rat urine in it.
Infection can occur through contact with skin (i.e. contaminated water with open wound), mucosa or conjunctiva with water (i.e. drinking contaminated water or contaminated water through eye) or contaminated soil in the environment.
I didn’t go to any “water” places before I had the fever. However, I remembered that in the last few days before I had my fever, I ate out almost every night (stalls) when I hung out with my friends and I also went to many different food reviews.
And as my doctor agreed, that could also be the cause, in case some of the food or utensils are contaminated.
You see, I would usually order Coke (or other can drinks) when I eat out because I always felt it was the safer choice. Usually, I would wipe the mouth of the can with tissue before breaking the tab but, I was told that only wiping the mouth of the can with dry tissue is not enough. You should put it under running water for any “urine” or other dirty particles to wash away.
When I thought about it, there is a higher chance that I was infected during one of those days when I ate out.
Symptoms of Leptospirosis (Kencing Tikus)
The bacteria’s “incubation” period is usually 10 days. If you read about Leptospirosis (Kencing Tikus) and the symptoms, there are FOUR highly variable symptoms:
- Mild, influenza-like illness
- Weil’s syndrome characterised by jaundice, renal failure, haemorrhage and myocarditis with arrhythmias.
- Meningitis or Meningoencephalitis
- Pulmonary haemorrhage with respiratory failure
The above are very similar to dengue and other haemorrhagic fevers like malaria, typhoid, influenza and others that are common to tropical countries.
Which is why when I first got the chills at night and the red spots that morning, I thought I had dengue like what my brother had many years ago. The first thing I told the doctor at the Emergency was I suspected I had dengue.
Only blood test was able to determine whether it was Dengue or Leptospirosis (Kencing Tikus).
Other symptoms to look out for are:
- Myalgia particularly associated with the calf muscles and lumbar region
- Conjunctival suffusion
- Meningeal irritation
- Anuria or oliguria and/or proteinuria
- Hemorrhages (from the intestines and lungs)
- Cardiac arrhythmia or failure
- Skin rash
- Gastrointestinal symptoms such as nausea, vomiting, abdominal pain, diarrhoea
How To Cure Leptospirosis (Kencing Tikus)?
After my blood test showed I had Leptospirosis (Kencing Tikus), I was admitted immediately into KPJ Kajang.
I had to take 6 pills every day: Legalon 14mg, Doxycycline 100mg, Xyzal 5mg, Controloc 40mg, Motilium 10mg and Suniton (Orphenadrin & Paracetamol) – some were taken before food and some were taken after food. This was administered by the nurse (thank goodness!) for I was mostly in-and-out of space the first 2 days I was admitted.
IV drip was attached to me immediately when the doctor found out I had Leptospirosis (Kencing Tikus). This was also due to the fact I couldn’t keep any food or drink down.
My blood was drawn twice per day, especially because my doctor was not especially happy with my liver reading.
Like I wrote above, one of the symptoms of Leptospirosis (Kencing Tikus) was jaundice, because the bacteria also targets the liver. You only have one liver so regular liver readings could help determine the type of medication for you to take to eliminate the infection from your liver.
Another part that bothered me was my eyes. Remember I wrote the morning I went to the hospital, both my corneas (eyes) were red? According to the eye specialist, a clinical case associated with fever due to contaminated environment (animal urine) could be Conjunctival Suffusion.
Conjunctival suffusion is redness of the conjunctiva that resembles conjunctivitis but does not have inflammatory exudates (i.e. pus or clear fluid).
My eye specialist prescribed two eye drops to use every 4 hours every day: Fluorometholone 0.1% and Ciprofloxacin. The number of times to use the eye drop will lessen once the redness subside. I had to meet her every morning to determine if the swelling subsides. The eye drop can only be used for 30 days after it is first opened.
I hated the eye drop though because I could taste it in the back of my throat. Yech!
I was hospitalised for 5 days because my liver reading was not good. My doctor was not very happy with the slow improvement of my liver.
I was quite bored after my third day so on the fifth day, he decided I should go home. He packed medications that would last me for two weeks and told me to rest and recover my strength with proper and healthy food.
Stay tuned for the Second part of my Hospitalization episode.