Massive ocular hemorrhage resulting in blindness in a patient with the sickle cell trait who developed leptospirosis. Case report

Costa, Eduardo; Lopes, Antônio Alberto; Sacramento, Edilson; Santos, P. A. B.

doi:10.1590/s0036-46652000000500009

Cited by 5 publications

(2 citation statements)

References 10 publications

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“…Leptospirosis is a worldwide zoonotic disease caused by Leptospira interrogans 10,14,15,18 . The severe cases are characterized by a high frequency of jaundice, acute renal failure, bleeding complications, heart failure, cardiac arrhythmias and respiratory failure 6,10,17,19,20,22 . In Salvador, a large city located in the state of Bahia in Northeast Brazil, the disease is endemic with outbreaks occurring in close relation to the increase in the pluviometric precipitation 4,5,16 .…”

Section: Introductionmentioning

confidence: 99%

Penicillin at the late stage of leptospirosis: a randomized controlled trial

Costa

Lopes

Sacramento

et al. 2003

Rev. Inst. Med. trop. S. Paulo

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There is evidence that an early start of penicillin reduces the case-fatality rate of leptospirosis and that chemoprophylaxis is efficacious in persons exposed to the sources of leptospira. The existent data, however, are inconsistent regarding the benefit of introducing penicillin at a late stage of leptospirosis. The present study was developed to assess whether the introduction of penicillin after more than four days of symptoms reduces the in-hospital case-fatality rate of leptospirosis. A total of 253 patients aged 15 to 76 years with advanced leptospirosis, i.e., more than four days of symptoms, admitted to an infectious disease hospital located in Salvador, Brazil, were selected for the study. The patients were randomized to one of two treatment groups: with intravenous penicillin, 6 million units day (one million unit every four hours) for seven days (n = 125) and without (n = 128) penicillin. The main outcome was death during hospitalization. The case-fatality rate was approximately twice as high in the group treated with penicillin (12%; 15/125) than in the comparison group (6.3%; 8/128). This difference pointed in the opposite direction of the study hypothesis, but was not statistically significant (p = 0.112). Length of hospital stay was similar between the treatment groups. According to the results of the present randomized clinical trial initiation of penicillin in patients with severe forms of leptospirosis after at least four days of symptomatic leptospirosis is not beneficial. Therefore, more attention should be directed to prevention and earlier initiation of the treatment of leptospirosis.

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Section: Introductionmentioning

confidence: 99%

Penicillin at the late stage of leptospirosis: a randomized controlled trial

Costa

Lopes

Sacramento

et al. 2003

Rev. Inst. Med. trop. S. Paulo

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“…Also, optic disc oedema, retinal vasculitis, retinal haemorrhage, hard exudates and papillitis were reported in 4.8% each [42]. Moreover, Costa et al in Brazil described a patient with sickle cell anaemia who presented with massive bilateral vitreous haemorrhage with retinal detachment and phthisis bulbis in the context of leptospiral infection [43].…”

Section: Ocular Involvementmentioning

confidence: 99%