Leptospirosis in the United States

Heath, Clark W.; Alexander, A. D.; Galton, Mildred M.

doi:10.1056/nejm196510212731706

Cited by 133 publications

(34 citation statements)

References 10 publications

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“…These symptoms are consistent with those reported in other series [4]. The mortality rate of 7% was within the range of 4 - 10% reported in studies from France and the USA [5, 6]. Differences in the mortality rate can be attributed to the criteria chosen for patient inclusion and to the severity of the disease.…”

Section: Discussionsupporting

confidence: 90%

Intensive Care of a Weil’s Disease With Multiorgan Failure

et al. 2010

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Leptospirosis is a commonly encountered type of zoonosis, especially in tropical regions. There is insufficient data regarding its frequency in non-tropical regions such as Turkey. Although leptospirosis presents with a mild icteric form in nearly 90% of cases, it can lead to Weils disease characterized by fever as well as fulminant hepatorenal and respiratory failure, in approximately 5 - 10% of cases. In this case report, we present a patient with Weil's disease, complicated with multiorgan failure.KeywordsWeil's disease; Leptospirosis; Multiorgan failure

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Section: Discussionsupporting

confidence: 90%

Intensive Care of a Weil’s Disease With Multiorgan Failure

et al. 2010

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“…Case series of leptospiroses shows that the disease is more frequent in young adults, aged 20–39 years [5, 21, 22]. Patients with leptospirosis-associated acute kidney injury are older, with ages between 34 and 48 years [22].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Oliguric Acute Kidney Injury in Leptospirosis

Daher

Silva²,

Karbage³

et al. 2009

Nephron Clin Pract

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Background: Acute kidney injury (AKI) occurs in 10 to 60% of patients with leptospirosis. The aim of this study is to investigate markers for oliguric AKI in leptospirosis. Methods: A retrospective study was performed with 196 consecutive patients with leptospirosis-associated AKI. These patients were categorized into either oliguric or non-oliguric according to their urine output. Clinical and laboratory characteristics were compared between the two groups. Results: Among these patients, 64 (32.6%) were oliguric and 132 (67.4%) nonoliguric. Markers for oliguria were age higher than 40 years (OR = 1.02, p = 0.04), hyponatremia (OR = 0.94, p = 0.03), elevated serum creatinine (OR = 1.11, p = 0.04), low arterial pH (OR = 1.0002, p = 0.01), high levels of AST (OR = 1.005, p = 0.01), crackles (OR = 3.83, p < 0.001) and direct bilirubin (OR = 1.03, p = 0.03). Elevated activated prothrombin time (OR = 0.97, p = 0.03) was a factor associated with nonoliguric AKI. Independent markers for oliguria were crackles (OR = 5.17, p = 0.0016) and direct bilirubin levels (OR = 1.051, p = 0.04). Mortality was significantly higher in oliguric than nonoliguric (27 vs. 8%, p < 0.001). Renal function at discharge was similar in oliguric and nonoliguric patients. Conclusion: Age higher than 40 years, hyponatremia, elevated serum creatinine, low arterial pH, high levels of AST, crackles and direct bilirubin levels would be useful to early identify patients with oliguric AKI in leptospirosis.

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“…Symptomatic Leptospira infection is often characterized as febrile illness accompanied by other symptoms including headache, conjunctival suffusion, muscle pains, and meningismus (26,27). Yet some persons may have clinically inapparent infection or symptoms too mild to be definitively diagnosed, especially in disease-endemic areas (7,28).…”

Section: Discussionmentioning

confidence: 99%

Leptospirosis: Skin Wounds and Control Strategies, Thailand, 1999

Phraisuwan

Whitney

Tharmaphornpilas

et al. 2002

Emerg. Infect. Dis.

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After an outbreak of leptospirosis in workers who participated in cleaning a pond during September 1999 in Thailand, a serologic survey was conducted. Among a cohort of 104 persons from one village who participated in pond cleaning activity, 43 (41.3%) were seropositive for immunoglobulin M antibodies against Leptospira , indicating recent infection. Only 17 (39.5%) of 43 seropositive persons reported a recent febrile illness; the remaining seropositive persons were considered asymptomatic, suggesting that asymptomatic leptospirosis infection may be common where leptospirosis is endemic. Multivariable logistic regression indicated that wearing long pants or skirts was independently protective against leptospirosis infection (OR adjusted = 0.217), while the presence of more than two wounds on the body was independently associated with infection (OR adjusted = 3.97). Educational efforts should be enhanced in areas where leptospirosis is endemic to encourage the use of protective clothing. In addition wound management and avoidance of potentially contaminated water when skin wounds are present should be included in health education programs.

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Leptospirosis in the United States

Cited by 133 publications

References 10 publications

Intensive Care of a Weil’s Disease With Multiorgan Failure

Intensive Care of a Weil’s Disease With Multiorgan Failure

Predictors of Oliguric Acute Kidney Injury in Leptospirosis

Leptospirosis: Skin Wounds and Control Strategies, Thailand, 1999

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