Hemoptise/s e síndrome de angústia respiratória do adulto como causas de morte na leptospirose: mudanças de padrões clínicos e anatomopatológicos

Aj, Gonçalves; Je, de Carvalho; Jb, Guedes; Rozembaum, Ronaldo; Ar, Vieira

doi:10.1590/s0037-86821992000400009

Cited by 32 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is in agreement with the data in the scientific literature which describe bleeding as the main cause of death in leptospirosis 10,16,25 .…”

Section: Discussionsupporting

confidence: 93%

“…In the current study, the majority of patients with severe forms of leptospirosis presented with some type of alteration in hemostasis with subsequent hemorrhagic manifestations that occurred, on average, after the first week of symptom onset; this period began on the ninth day and corresponds to the beginning of the immunological phase of the disease. The complication most frequently found was of pulmonary nature with clinical manifestation in the form of hemoptysis, thus revealing the recent presentation, in our midst, of pulmonary complaints associated with severe forms of leptospirosis 1,2,3,5,10 .…”

Section: Discussionmentioning

confidence: 66%

See 1 more Smart Citation

Evaluation of hemostasis disorders and anticardiolipin antibody in patients with severe leptospirosis

Daher

Neto

Ramirez

2002

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

A prospective study was designed to evaluate disorders of hemostasis and levels of anticardiolipin antibodies (ACL) in 30 patients with severe leptospirosis and acute renal failure (ARF) (ARF was defined as serum creatinine > or = 1.5 mg/dL). The patients had been admitted to the Walter Cantídio University Hospital, São José Infectious Diseases Hospital and General Hospital of Fortaleza, Ceará, from August 1999 to July 2001. They all were male, with a mean age of 32 ± 14 years and with clinical and laboratory diagnoses of ARF leptospirosis. The time elapsed between onset of symptoms and the first hemorrhagic manifestation was 9 ± 4 days. Bleeding was observed in 86% of the patients. Laboratory tests showed significantly high levels of urea (181 ±95 mg/dl), fibrinogen, (515 ± 220 mg/dl), prothrombin time (13.3 ± 0.9 seconds) and low platelet counts (69 ± 65x10³/mm³) on admission. There was no elevation in activated partial thromboplastin time or thrombin time. Levels of IgM and IgG ACL concentrations were significantly increased (p < 0.05) in leptospirosis patients when compared to control patients (28.5 ± 32.4 vs. 11.5 ± 7.9MPL U/ml and 36.7 ± 36.1 vs. 6.5 ± 2.5 GPL U/ml), respectively. Vasculitis, thrombocytopenia and uremia should be considered important factors for the pathogenesis of hemorrhagic disturbances and the main cause of death in severe leptospirosis.

show abstract

“…This is in agreement with the data in the scientific literature which describe bleeding as the main cause of death in leptospirosis 10,16,25 .…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 66%

Evaluation of hemostasis disorders and anticardiolipin antibody in patients with severe leptospirosis

Daher

Neto

Ramirez

2002

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

show abstract

“…The lungs are an important target organ in leptospirosis presenting hemorrhagic pneumonitis with varying degrees of severity. 9,10 The pathophysiology of pulmonary injury in leptospirosis is poorly understood. Vascular pulmonary injury is thought to be the outcome of immunologic mechanisms with a disseminated intravascular coagulation-like reaction caused by Leptospira toxins.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Disease in Hamsters Infected with Leptospira interrogans: Histopathologic Findings and Cytokine mRNA Expressions

Marinho

Oliveira-Júnior²,

Monteiro³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Our aim was to evaluate the pulmonary changes induced by Leptospira interrogans infection in hamsters, and the gene expression of endogenous mediators in lung fragments during 28 days of observation. The animals were euthanized on days 4, 7, 14, 21, and 28 post-inoculation. Histopathologic lung analysis showed hemorrhage, pneumonia, alveolar congestion, and infiltrated cellular areas, with increasing severity until day 21 post-inoculation. Tumor necrosis factor (TNF)-a mRNA expression enhanced in first days with peak on day 4 and slightly decreased in the final phase. The interleukin (IL)-10 remained relatively constant throughout the period, with the exceptions of days 4 and 14. The endothelial nitric-oxide synthesis (eNOS) showed an increased expression on day 4, followed by an augment on days 7 and 14, and remaining constant up to day 28 post-infection. Our results demonstrate that inoculation of L. interrogans sorovar Icterohaemorrhagiae induced pulmonary lesions, including pulmonary hemorrhage, supporting that the lung is a target organ.

show abstract

“…[17][18][19][20] Nas formas pulmonares, a leptospirose causa reação inflamatória, caracterizada por infiltração de monócitos e neutrófilos, que pode ser surpreendentemente leve quando comparado com o dano vascular. 15,16 Tal reação pode ser acompanhada de edema pulmonar, deposição de fibrina e reações proliferativas fibroblásticas.…”

Section: Discussionunclassified

“…Essas alterações podem levar à hemorragia intra-alveolar e síndrome respiratória aguda, o que é muitas vezes fatal. 17,18 Os sintomas iniciais são dispneia e hemoptise, combinados com anomalias na ausculta, que podem ser indicativos de grave envolvimento pulmonar. Tais sintomas geralmente começam entre o quarto e sexto dia da doença, que pode ser fatal, em menos de 72 horas.…”

Section: Discussionunclassified

Hemorragia pulmonar resultante de leptospirose

Filho

Cavalheiro

Pedroso

2016

Rev. Fac. Ciênc. Méd. Sorocaba

View full text Add to dashboard Cite

RESUMOA leptospirose é uma das zoonoses mais difundidas no mundo, embora os mecanismos de patogênese das espiroquetas pertencentes ao gênero Leptospira sejam em grande parte desconhecidos. A infecção humana ocorre tanto por contato direto com animais infectados ou indiretamente, através do contato com água contaminada pela urina ou solo, à medida que as espiroquetas facilmente penetram a pele humana. O presente relato expõe o caso de uma paciente do sexo feminino, diagnosticada com leptospirose após ter tido contato com cão infectado por Leptospira sp. que apresentou quadro de hemorragia pulmonar, síndrome da angústia respiratória aguda e insuficiência renal aguda. Palavras-chave: leptospirose; hemorragia; pulmão; síndrome do desconforto respiratório do adulto. ABSTRACTLeptospirosis is one of the most widespread zoonoses in the world, although the mechanisms responsible for the pathogenesis of spirochetes of the genus Leptospira are largely unknown. Human infection occurs either by direct contact with infected animals or indirectly, through contact with water or soil contaminated with urine, as the spirochetes easily penetrate human skin. The present report exposes the case of a female patient, diagnosed with leptospirosis after having had contact with a dog infected by Leptospira sp. that developed pulmonary hemorrhage, acute respiratory distress syndrome and acute renal failure. Keywords: leptospirosis; hemorrhage; lung; respiratory distress syndrome, adult. InTROdUçãOA leptospirose é uma das zoonoses mais difundidas no mundo, embora os mecanismos de patogênese das espiroquetas pertencentes ao gênero Leptospira, que inclui tanto espécies patogênicas como saprófitas Leptospira, são em grande parte desconhecidos. Caracteriza um problema emergente em saú-de pública, principalmente nos grandes centros urbanos de países em desenvolvimento, fator agravado pela sua ampla distribuição geográfica. Ocorre tanto em áreas rurais como urbanas de zonas tropicais, subtropicais e regiões temperadas. Os surtos de doenças nos países desenvolvidos são normalmente associados à exposição ocupacional, turismo ou eventos esportivos. Os países em desenvolvimento têm a maior carga da doença, com meio milhão de casos registrados por ano e uma taxa de mortalidade variando de 5 a 10%. [1][2][3][4][5][6][7][8] Em resumo, as bactérias espiroquetas do gênero Leptospira são capazes de sobreviver no ambiente por longos períodos de tempo, especialmente em áreas quentes e úmidas. As formas patogênicas do Leptospira sp. podem infectar muitos tipos diferentes de mamíferos (a exemplo: roedores, porcos e cães), que excretam as bactérias em sua urina. A infecção humana ocorre tanto por contato direto com animais infectados ou indiretamente, através do contato com água contaminada pela urina ou solo; à medida que as espiroquetas facilmente penetram a pele humana. 9-11Várias espécies patogênicas do gênero Leptospira podem causar uma grande variedade de manifestações clínicas, que variam desde uma leve síndrome gripal a uma forma de doença grave, carac...

show abstract

Hemoptise/s e síndrome de angústia respiratória do adulto como causas de morte na leptospirose: mudanças de padrões clínicos e anatomopatológicos

Cited by 32 publications

References 19 publications

Evaluation of hemostasis disorders and anticardiolipin antibody in patients with severe leptospirosis

Evaluation of hemostasis disorders and anticardiolipin antibody in patients with severe leptospirosis

Pulmonary Disease in Hamsters Infected with Leptospira interrogans: Histopathologic Findings and Cytokine mRNA Expressions

Hemorragia pulmonar resultante de leptospirose

Contact Info

Product

Resources

About