Pulmonary haemorrhage as a predominant cause of death in leptospirosis in Seychelles

Yersin, Claude; Bovet, Pascal; Mérien, Fabrice; Clément, Jan; Laille, M.; Ranst, Marc Van; Perolat, P.

doi:10.1016/s0035-9203(00)90445-0

Cited by 86 publications

(58 citation statements)

References 28 publications

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“…Whereas pulmonary manifestations were reported to be less prominent in the past, with hemoptysis being observed in 3-25% of patients and chest pain in 10%, epidemics of leptospirosis wherein pulmonary manifestations dominated the clinical pictures have been reported since the late 1980s [8][9][10][11][12][13]. Alveolar hemorrhage presented as dyspnea and hemoptysis is the main pulmonary manifestation in leptospirosis; it may vary from mild to severe, severity being related to mortality [5,14].…”

Section: Pulmonary Involvement In Leptospirosismentioning

confidence: 99%

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

Dolhnikoff¹,

Mauad²,

Bethlem³

et al. 2007

Braz J Infect Dis

118

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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Section: Pulmonary Involvement In Leptospirosismentioning

confidence: 99%

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

Dolhnikoff¹,

Mauad²,

Bethlem³

et al. 2007

Braz J Infect Dis

118

102

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show abstract

“…2,3 Clinical manifestations of leptospirosis range from a self-limited febrile illness with headache and muscle pain, to severe, life-threatening disease forms such as Weil's disease, characterized by jaundice, renal failure and bleeding, and severe pulmonary hemorrhage syndrome. [4][5][6] Leptospirosis has been traditionally considered to be a rural-based disease. 4 However, urban epidemics have emerged to become a major public health problem in developing countries.…”

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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“…In 5 to 15% of clinical infections, progression to severe multisystemic complications occurs, such as jaundice, renal failure and bleeding disorders [1]. Pulmonary symptoms and signs in patients with leptospirosis have been infrequently described, but in recent years this scenario has changed, with cases of severe hemoptysis and acute respiratory failure (ARF) being described [8][9][10][11][12]. When ARF is present, dyspnea, pulmonary edema, alveolar and interstitial hemorrhages are common clinical-pathological features.…”

mentioning

confidence: 99%

Leptospirosis as a cause of acute respiratory failure: clinical features and outcome in 35 critical care patients

Vieira

Brauner²

2002

Braz J Infect Dis

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Leptospirosis may have important complications, such as acute respiratory failure (ARF) associated or not with other organic dysfunction, with a high mortality rate. We report the characteristics and evolution of severe leptospirosis associated with ARF. During 10 years, 35 consecutive adult patients admitted in two general Intensive Care Units with severe leptospirosis and ARF, were followed up. Clinical characteristics, associated organic dysfunction and mortality were analyzed. Survivors were compared with non-survivors. The most frequent clinical manifestations were dyspnea, fever, myalgia, jaundice, hemoptysis and coughing. All patients presented ARF, needing mechanical ventilation, as well as other organic dysfunctions. The mortality rate was 51%. Non-survivors were older and had a higher incidence of organic dysfunction, mainly renal, cardiovascular and neurological failures, as well as a higher level of acidosis. In conclusion, leptospirosis should be considered as a cause of severe ARF and other associated organic dysfunctions.

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Pulmonary haemorrhage as a predominant cause of death in leptospirosis in Seychelles

Cited by 86 publications

References 28 publications

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

Pathology and pathophysiology of pulmonary manifestations in leptospirosis

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

Leptospirosis as a cause of acute respiratory failure: clinical features and outcome in 35 critical care patients

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