Leptospirosis in Latin America

Lomar, André Villela; Diament, Décio; Torres, Jaime R.

doi:10.1016/s0891-5520(05)70216-6

Cited by 75 publications

(83 citation statements)

References 49 publications

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“…These are the most common findings reported in leptospirosis. 1,7,8,9,17,19 Hemorrhagic manifestations are characteristic of Weil disease, and are potentially fatal. Patients can develop important hemodynamic abnormalities, secondary to hypovolemia, which is caused by dehydration and direct effects of Leptospira toxins that damages vascular endothelium and increases permeability.…”

Section: Discussionmentioning

confidence: 99%

“…Fever, chills, headache, severe myalgia, conjunctival suffusion, anorexia, nausea, vomiting, and malaise usually characterizes acute leptospirosis. [7][8][9] Pulmonary involvement and acute kidney injury are the main causes of death in leptospirosis. [10][11][12] Renal involvement in leptospirosis is characterized by acute interstitial nephritis that may be associated with acute tubular necrosis.…”

Section: Introductionmentioning

confidence: 99%

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Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

Daher¹,

Lima²,

Júnior³

et al. 2010

Braz J Infect Dis

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INTRODUCTION: leptospirosis is a zoonosis of worldwide importance. The disease is endemic in Brazil. This study was conducted to describe the clinical and laboratory presentation of leptospirosis in a metropolitan city of Brazil. METHODS: this is a retrospective study including 201 consecutive patients with leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil, between 1985 and 2006. All patients had clinical and epidemiological data suggestive of leptospirosis, and positive laboratorial test for leptospirosis (microscopic agglutination test, MAT, higher than 1:800). RESULTS: a total of 201 patients were included, with mean age of 38.9 ± 15.7 years; 79.1% were male. The mean length from onset of symptoms to admission was 7 ± 3 days. The main clinical signs and symptoms at admission were fever (96.5%), jaundice (94.5%), myalgia (92.5%), headache (74.6%), vomiting (71.6%) and dehydration (63.5%). Hemorrhagic manifestations were present in 35.8%. Acute kidney injury was found in 87% of the patients. Platelet count was less than 100,000/mm³ in 74.3%. Hematuria was found in 42.9%. Death occurred in 31 cases (15.4%). CONCLUSIONS: leptospirosis is a globally relevant disease with potential fatal outcome. Signs and symptoms suggestive of leptospirosis must be known by any physician in order to institute early adequate treatment to improve outcome. Early indication and daily hemodialysis seems to be beneficial in this group of patients

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

Daher¹,

Lima²,

Júnior³

et al. 2010

Braz J Infect Dis

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“…Hemoptysis occurred in 50% of 168 cases in China between 1959 and 1960 [21] and in 13% of 115 patients hospitalized with severe leptospirosis in Brazil [22]. In the Spanish series of 26 patients with leptospirosis, 17 had respiratory symptoms, such as dyspnea (seven patients); hemoptysis with bloodstained sputum (seven patients); cough (six patients), and pleuritic chest pain (five patients) [3].…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

Dolhnikoff¹,

Mauad²,

Bethlem³

et al. 2007

Braz J Infect Dis

114

102

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Leptospirosis is a re-emerging zoonosis occurring as large outbreaks throughout the world caused by Leptospira interrogans. The incidence of pulmonary involvement in leptospirosis has been reported to be increasing in the last years, affecting up to 70% of the patients. Alveolar hemorrhage presented as dyspnea and hemoptysis is the main pulmonary manifestation. The emergence of massive hemoptysis and acute respiratory distress syndrome has characterized the recent changes reported in the clinical patterns of leptospirosis. The pulmonary involvement has been emerged as a serious life threat, becoming the main cause of death due to leptospirosis in some countries. In this review we present the main clinical and pathological manifestations of pulmonary involvement in leptospirosis, with special focus on recent data concerning the pathophysiological mechanisms underlying lung injury.

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“…4 However, urban epidemics have emerged to become a major public health problem in developing countries. 7 In Brazil, epidemics of leptospirosis have been reported since the 1960s in major cities such as São Paulo, 8 Rio de Janeiro, 9 Recife, 10 and Salvador 11 following periods of heavy rainfall. Transmission presumably occurs through contact with floodwater contaminated with urine of infected rats.…”

Section: Introductionmentioning

confidence: 99%

Referral pattern of leptospirosis cases during a large urban epidemic of dengue.

Flannery¹,

Pereira²,

de³

et al. 2001

The American Journal of Tropical Medicine and Hygiene

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Abstract. During heavy seasonal rainfall in 1996, concurrent epidemics of dengue and leptospirosis occurred in an urban center in northeastern Brazil. We interviewed 110 cases of leptospirosis hospitalized a median of seven days after the onset of illness to evaluate the impact of the dengue epidemic on the triage of suspected leptospirosis from ambulatory clinics to the infectious disease reference hospital. Within the first three days of illness, 46 (42%) cases sought their first medical evaluation, and 28 (61% of 46) received a diagnosis of dengue. Dengue diagnoses were associated with a median of five days delay in referral to the infectious disease hospital. Patients who reported initial diagnoses of dengue were more likely than other patients to have required admission to the intensive care unit (odds ratio [OR] ϭ 2.7, 95% confidence interval [CI] ϭ 0.8-9.5) and to have died during hospitalization (OR ϭ 5.1, 95% CI ϭ 0.8-55.0). These findings indicate that diagnostic confusion between the early symptoms of leptospirosis and dengue may have contributed to the high mortality observed during the leptospirosis epidemic.

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Leptospirosis in Latin America

Cited by 75 publications

References 49 publications

Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

Referral pattern of leptospirosis cases during a large urban epidemic of dengue.

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