Arrhythmias in leptospirosis-associated acute kidney injury: a case series

Soares, Douglas de Sousa; Galdino, Gabriela Studart; Rodrigues, Bruna Custódio; Silva, Geraldo Bezerra da; Daher, Elizabeth De Francesco

doi:10.1016/j.bjid.2016.11.010

Cited by 4 publications

(6 citation statements)

References 4 publications

(3 reference statements)

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“…Gancheva et al stated that co-morbidities contributed significantly to death in elderly patients 7 . Others evidenced that cardiac involvement, including arrhythmias, heart failure and myocardial infarction were linked to death, especially in severe cases [31][32][33]. However, the most frequently cited cause of death in leptospirosis is AKI.…”

Section: Discussionmentioning

confidence: 99%

Leptospirosis in the elderly: the role of age as a predictor of poor outcomes in hospitalized patients

Daher

Soares

Galdino

et al. 2019

Pathogens and Global Health

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Background: The aim of this study was to investigate factors associated with poor outcomes among elderly hospitalized patients with leptospirosis. Methods: This is a retrospective cohort study with leptospirosis patients admitted to three tertiary hospitals in Fortaleza, Brazil, from January 1985 to July 2017. Patients were divided into two groups: elderly (age ≥60 years) and young (age <60 years). A comparison of demographical, clinical and laboratory data, treatment and outcomes was executed in order to investigate differences between groups. Results: A total of 507 hospitalized patients were included, with mean age 38 ± 15 years. Elderly group presented lower incidence of myalgia, vomiting, and dyspnea, as well as, higher medium systolic blood pressure. Elderly also manifested higher frequency of AKI (85.9 vs. 74.7%, p = 0.05), hemodialysis requirement (54.7 vs. 37.0%, p = 0.007) and death (32.8 vs. 12.2%, p < 0.001). In multivariate analysis, age ≥60 years was a predictor of hemodialysis requirement (p = 0.008, OR = 2.049, 95% CI = 1.207-3.477) and death (p < 0.001, OR = 3.520, 95% CI = 1.940-6.386). Conclusion: Leptospirosis in the elderly is associated with less hemodynamic impairment and higher frequency of AKI. Advanced age was also a predictor of poor outcomes, such as hemodialysis requirement and death, mostly due to kidney involvement.

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Section: Discussionmentioning

confidence: 99%

Leptospirosis in the elderly: the role of age as a predictor of poor outcomes in hospitalized patients

Daher

Soares

Galdino

et al. 2019

Pathogens and Global Health

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“…In addition, the presence of transient ECG abnormalities are found in 70% of the patients but are rarely noticed at the beginning of the disease. It is possibly caused by the effect of Leptospira or the febrile illness combined with metabolic and electrolyte abnormalities 1 , 3 , 7 , 8 , 16 . Even though cardiac manifestations are usually not fatal, and cardiac involvement in leptospirosis tends to predict a poor prognosis e of the disease 16 , 17 .…”

Section: Discussionmentioning

confidence: 99%

“…ECG changes include sinus tachycardia, supraventricular extra-systoles, atrioventricular block and atrial fibrillation, the most common form of arrhythmia in patients with leptospirosis 16 , 18 .…”

Section: Discussionmentioning

confidence: 99%

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Pancreatitis as a severe complication of leptospirosis with fatal outcome: a case report

Gomes

Brilhante

Carvalho

et al. 2019

Rev. Inst. Med. trop. S. Paulo

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Leptospirosis is a globally distributed zoonosis with a broad clinical spectrum. This disease mostly affects liver and kidney tissues. Other organs such as the pancreas, can be affected by leptospirosis-induced vasculitis. In addition, cardiac manifestations are common, and the presence of transient ECG abnormalities can be found in 70% of the patients. We report a male patient who presented with an atypical leptospirosis that progressed with severe acute pancreatitis, acute kidney injury and atrial fibrillation. Early diagnosis and adequate supportive therapy are crucial for the appropriated management of symptoms.

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“…Além disso, o uso de Sistema de Informações Geográficas (SIG) em estudos na área da saúde emerge como uma importante ferramenta na inferência espacial em doenças infecciosas. Entretanto, estudos voltados à análise da leptospirose ainda são restritos 18-20 , muitas vezes voltados a dados clínicos [21][22][23][24][25] .…”

Section: Introductionunclassified

Análise espacial da leptospirose no Brasil

et al. 2020

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RESUMO A leptospirose é um problema de saúde pública mundial. No Brasil, ela é uma doença de notificação compulsória e está relacionada a áreas com precárias condições sanitárias. Foi realizado um estudo ecológico retrospectivo para observar a distribuição espacial e temporal de casos confirmados da leptospirose em escala nacional no período entre 2007 e 2017. A espacialização da leptospirose utilizou técnicas de geoprocessamento por análise de padrões pontuais e por mapas de densidade Kernel. Os resultados revelaram que, no período, foram registrados 42.310 casos confirmados de leptospirose no País, com média anual de 3.846 casos e prevalência de 1,9 a cada 100 mil habitantes. As localidades com mais casos prevalentes foram as regiões Sul e Norte. O Sudeste apresentou taxa de prevalência inferior à taxa nacional em virtude da alta densidade demográfica. O método Kernel se mostrou útil na análise global da situação epidemiológica da leptospirose nas regiões do Brasil.

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Arrhythmias in leptospirosis-associated acute kidney injury: a case series

Cited by 4 publications

References 4 publications

Leptospirosis in the elderly: the role of age as a predictor of poor outcomes in hospitalized patients

Leptospirosis in the elderly: the role of age as a predictor of poor outcomes in hospitalized patients

Pancreatitis as a severe complication of leptospirosis with fatal outcome: a case report

Análise espacial da leptospirose no Brasil

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