Can findings on peripheral blood smear differentiate leptospirosis from other infections? A preliminary comparative study

Silva, Nipun Lakshitha de; Sivayoganathan, Sriharan; Sivashangar, Ahalya; Wickramasinghe, Wasanthi; Gooneratne, Lallindra; Rajapakse, Senaka

doi:10.1093/trstmh/try024

Cited by 5 publications

(6 citation statements)

References 5 publications

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“…Peripheral blood smears help to analyze the amount, size, and morphology of platelets; determine excessive platelet destruction or consumption [34]; identify pseudothrombocytopenia [8,9]; and differentiate acute febrile diseases such as sepsis, dengue, and Leptospira infection through granulocytic changes [35]. On peripheral blood smear, aberrant morphology of red blood cells or red blood cell fragments is a characteristic feature of TMA [36].…”

Section: Recommendation 9: Peripheral Blood Smears Can Help Diagnosementioning

confidence: 99%

Expert consensus on the diagnosis and treatment of thrombocytopenia in adult critical care patients in China

Song¹,

Liu

Zhu

et al. 2020

Military Med Res

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Thrombocytopenia is a common complication of critical care patients. The rates of bleeding events and mortality are also significantly increased in critical care patients with thrombocytopenia. Therefore, the Critical Care Medicine Committee of Chinese People's Liberation Army (PLA) worked with Chinese Society of Laboratory Medicine, Chinese Medical Association to develop this consensus to provide guidance for clinical practice. The consensus includes five sections and 27 items: the definition of thrombocytopenia, etiology and pathophysiology, diagnosis and differential diagnosis, treatment and prevention.

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Section: Recommendation 9: Peripheral Blood Smears Can Help Diagnosementioning

confidence: 99%

Expert consensus on the diagnosis and treatment of thrombocytopenia in adult critical care patients in China

Song¹,

Liu

Zhu

et al. 2020

Military Med Res

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“…Together, the findings in human and murine studies suggest that neutrophils do not seem to be an efficient defence factor for pathogenic Leptospira (Werts, ). On the other hand, it is well known that human leptospirosis presents neutrophilia, which correlates with severity (de Silva et al, ; Lindow et al, ; Raffray et al, ) and the pathogenic serovar involved (Craig et al, ).…”

Section: Introductionmentioning

confidence: 99%

Leptospiraspecies promote a pro‐inflammatory phenotype in human neutrophils

Charó

Scharrig

Ferrer

et al. 2018

Cellular Microbiology

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Leptospirosis is a global zoonosis caused by pathogenic Leptospira. Neutrophils are key cells against bacterial pathogens but can also contribute to tissue damage. Because the information regarding the role of human neutrophils in leptospirosis is scant, we comparatively analysed the human neutrophil's response to saprophytic Leptospira biflexa serovar Patoc (Patoc) and the pathogenic Leptospira interrogans serovar Copenhageni (LIC). Both species triggered neutrophil responses involved in migration, including the upregulation of CD11b expression, adhesion to collagen, and the release of IL‐8. In addition, both species increased levels of pro‐inflammatory IL‐1β and IL‐6 associated with the inflammasome and NFκB pathway activation and delayed neutrophil apoptosis. LIC was observed on the neutrophil surface and not phagocytized. In contrast, Patoc generated intracellular ROS associated with its uptake. Neutrophils express the TYRO3, AXL, and MER receptor protein tyrosine kinases (TAM), but only LIC selectively increased the level of AXL. TLR2 but not TLR4‐blocking antibodies abrogated the IL‐8 secretion triggered by both Leptospira species. In summary, we demonstrate that Leptospira species trigger a robust neutrophil activation and pro‐inflammatory response. These findings may be useful to find new diagnostic markers and therapeutic strategies against leptospirosis.

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“…17 In leptospirosis, there will be the presence of reactive lymphocytes in a background of neutrophilic leucocytosis/ toxic granulation in neutrophils. 18 Enteric fever cases show leucopenia, neutropenia with relative lymphocytosis. 19 Rickettsia infects endothelial cells, neutrophils, monocytes, macrophages, dendritic cells and lymphocytes resulting in increased volume of neutrophils, lymphocytes and monocytes during the febrile episodes.…”

Section: Discussionmentioning

confidence: 99%

“…Other clues in dengue include leucopenia, thrombocytopenia, monocytosis, presence of atypical lymphocytes with reversal of neutrophil/lymphocyte ratio 17 . In leptospirosis, there will be the presence of reactive lymphocytes in a background of neutrophilic leucocytosis/toxic granulation in neutrophils 18 . Enteric fever cases show leucopenia, neutropenia with relative lymphocytosis 19 .…”

Section: Discussionmentioning

confidence: 99%

Discriminant value of automated leucocyte VCS parameters in the detection of tropical infections

Muthunatarajan

Basavaiah

Shenoy

et al. 2021

Clinical Laboratory Analysis

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Introduction: In India, infectious diseases are a leading treatable cause of morbidity and mortality. Mangalore being endemic to many vector-borne diseases, their incidence is known to show seasonal variations with sharp increase during monsoon.Leucocytes have substantial role in the immunological pathogenesis of infections. Methods:The present series was a hospital-based cross-sectional study performed in a tertiary care hospital for a period of three months from June-August wherein the cell population data of cases of malaria, dengue, leptospirosis, typhoid and rickettsial infections along with equal number of healthy controls were collected and analysed.Effectiveness of leucocyte-related volume (V), conductivity (C) and scatter (S) parameters by Coulter®DXH800 haematology analyser in predicting these infections was appraised.Results: A total of 324 cases comprising of malaria (50%), dengue (30.9%), leptospirosis (13.9%), typhoid (4.0%) and rickettsial infections (1.2%) were included. There was statistically significant differences (P < 0.05) in the mean values of complete blood count parameters-haemoglobin, total leucocyte count, red blood cell count, haematocrit, red cell distribution width, differential leucocyte count, platelet count and plateletcrit between cases and controls and also between specific infections. The mean volumes of neutrophil, monocyte and lymphocyte were considerably increased in malaria and dengue fever compared to leptospirosis, typhoid and rickettsial infections. VCS parameters were the least altered in typhoid fever, except for a strikingly high conductivity and scatter of eosinophils.Conclusions: Haematological analysis is a part of routine evaluation of any case of febrile illness. This study showed that there are specific alterations in VCS parameters in different types of infections such as malaria, dengue, leptospira, typhoid and rickettsia, the information and analysis of which comes without any additional cost.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Can findings on peripheral blood smear differentiate leptospirosis from other infections? A preliminary comparative study

Abstract: Peripheral blood smear findings may be helpful in differentiating leptospirosis from other common acute febrile illnesses.

Cited by 5 publications

References 5 publications

Expert consensus on the diagnosis and treatment of thrombocytopenia in adult critical care patients in China

Expert consensus on the diagnosis and treatment of thrombocytopenia in adult critical care patients in China

Leptospiraspecies promote a pro‐inflammatory phenotype in human neutrophils

Discriminant value of automated leucocyte VCS parameters in the detection of tropical infections

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