Behavioural change: a rare presentation of leptospirosis

Tomacruz, Isabelle Dominique; Sandejas, Joanne Carmela M.; Berba, Regina; Sacdalan, Dennis Raymond

doi:10.1136/bcr-2019-230619

Cited by 8 publications

(2 citation statements)

References 8 publications

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“…Leptospirosis usually presents as a non-specific acute febrile illness with similar signs and symptoms to dengue, influenza, and rickettsial infections [ 8 ]. Despite its mild initial presentation, delayed intervention leads to severe and possibly fatal Weil’s disease, characterized by hemorrhage, jaundice, renal failure [ 1 ], and even nervous system involvement [ 9 ]. The clinicopathological features include azotemia, hyperbilirubinemia, elevated liver enzyme levels, and thrombocytopenia [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of antibiotics for treatment of leptospirosis: a systematic review and network meta-analysis

Ji,

Jian,

et al. 2024

Syst Rev

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Background Leptospirosis, an important zoonotic bacterial disease, commonly affects resource-poor populations and results in significant morbidity and mortality worldwide. The value of antibiotics in leptospirosis remains unclear, as evidenced by the conflicting opinions published. Methods We conducted a search in the PubMed, Web of Science, and Cochrane Library databases for studies. These studies included clinical trials and retrospective studies that evaluated the efficacy or safety of antibiotics for leptospirosis treatment. The primary outcomes assessed were defervescence time, mortality rate, and hospital stays. Subgroup analyses were performed based on whether there were cases involving children and whether there were cases of severe jaundice. Safety was defined as the prevalence of adverse events associated with the use of antibiotics. p scores were utilized to rank the efficacy of the antibiotics. Results There are included 9 randomized controlled trials (RCTs), 1 control trial (CT), and 3 retrospective studies (RS) involving 920 patients and 8 antibiotics. Six antibiotics resulted in significantly shorter defervescence times compared to the control, namely cefotaxime (MD, − 1.88; 95% CI = − 2.60 to − 1.15), azithromycin (MD, − 1.74; 95% CI = − 2.52 to − 0.95), doxycycline (MD, − 1.53; 95% CI = − 2.05 to − 1.00), ceftriaxone (MD, − 1.22; 95% CI = − 1.89 to − 0.55), penicillin (MD, − 1.22; 95% CI = − 1.80 to − 0.64), and penicillin or ampicillin (MD, − 0.08; 95% CI = − 1.01 to − 0.59). The antibiotics were not effective in reducing the mortality and hospital stays. Common adverse reactions to antibiotics included Jarisch–Herxheimer reaction, rash, headache, and digestive reactions (nausea, vomiting, diarrhea, abdominal pain, and others). Conclusions Findings recommend that leptospirosis patients be treated with antibiotics, which significantly reduced the leptospirosis defervescence time. Cephalosporins, doxycycline, and penicillin are suggested, and azithromycin may be a suitable alternative for drug-resistant cases. Systematic review registration PROSPERO CRD42022354938.

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Section: Introductionmentioning

confidence: 99%

Efficacy and safety of antibiotics for treatment of leptospirosis: a systematic review and network meta-analysis

Ji,

Jian,

et al. 2024

Syst Rev

View full text Add to dashboard Cite

show abstract

“…Leptospirosis usually presents as a nonspeci c acute febrile illness with similar signs and symptoms to dengue, in uenza, and rickettsial infections [8]. Despite its mild initial presentation, delayed intervention leads to severe and possibly fatal Weil's disease, characterized by hemorrhage, jaundice, renal failure [1], and even nervous system involvement [9]. The clinicopathological features include azotemia, hyperbilirubinemia, elevated liver enzyme levels, and thrombocytopenia [7].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of antibiotics for treatment of leptospirosis : A systematic review and network meta-analysis

Ji,

Jian,

et al. 2023

Preprint

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Background Leptospirosis, an important zoonotic bacterial disease, commonly affects resource-poor populations and results in significant morbidity and mortality worldwide. The value of antibiotics in leptospirosis remains unclear, as evidenced by the conflicting opinions published. Methods We conducted a search in the PubMed, Web of Science, and Cochrane Library databases for studies. These studies included clinical trials and retrospective studies that evaluated the efficacy or safety of antibiotics for leptospirosis treatment. The primary outcomes assessed were defervescence time, mortality rate, and hospital stays. Subgroup analyses were performed based on whether there were cases involving children and whether there were cases of severe jaundice. Safety was defined as the prevalence of adverse events associated with the use of antibiotics. P scores were utilized to rank the efficacy of the antibiotics. Results There are included 9 randomized controlled trials (RCTs), 1 control trial (CT), and 3 retrospective studies (RS) involving 920 patients and 8 antibiotics. Six antibiotics resulted in significantly shorter defervescence times compared to the control, namely cefotaxime (MD, -1.88; 95% CI= -2.60 to -1.15), azithromycin (MD, -1.74; 95% CI= -2.52 to -0.95), doxycycline (MD, -1.53; 95% CI= -2.05 to -1.00), ceftriaxone (MD, -1.22; 95% CI= -1.89 to -0.55), penicillin (MD, -1.22; 95% CI= -1.80 to -0.64), and penicillin or ampicillin (MD, -0.08; 95% CI= -1.01 to -0.59). The antibiotics were not effective for reducing the mortality and hospital stays. Common adverse reactions to antibiotics included Jarisch-Herxheimer reaction, rash, headache, and digestive reactions (nausea, vomiting, diarrhea, abdominal pain, and others). Conclusions Findings recommend that leptospirosis patients be treated with antibiotics, which significantly reduced the leptospirosis defervescence time. Cephalosporins, doxycycline, and penicillin are suggested, and azithromycin may be a suitable alternative for drug-resistant cases. PROSPERO registration number CRD42022354938

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Leptospirosis: Messing with Our Minds: A Review of Unusual Neurological and Psychiatric Complexities

Craig

Prior

Weier

et al. 2023

Zoonoses: Infections Affecting Humans and Animals

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Behavioural change: a rare presentation of leptospirosis

Cited by 8 publications

References 8 publications

Efficacy and safety of antibiotics for treatment of leptospirosis: a systematic review and network meta-analysis

Efficacy and safety of antibiotics for treatment of leptospirosis: a systematic review and network meta-analysis

Efficacy and safety of antibiotics for treatment of leptospirosis : A systematic review and network meta-analysis

Leptospirosis: Messing with Our Minds: A Review of Unusual Neurological and Psychiatric Complexities

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