Severe Leptospirosis - A case series and review

Habaragamuwa, B W P; Piyasiri, Gihan

doi:10.4038/slja.v19i1.2866

Cited by 5 publications

(6 citation statements)

References 3 publications

(2 reference statements)

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“…Previous studies performed in Sri Lanka, conducted in ICUs found a significantly high mortality rates of 65% 12 It was also demonstrated that mortality rate increased with higher number of system involvement. Renal involvement, hypotension and pulmonary involvement were noted to be the most frequent complications with central nervous system involvement associated with a poor overall prognosis.…”

Section: Leptospirosis In Intensive Care Settingsmentioning

confidence: 68%

“…In a Sri Lankan context, as previously mentioned a study done in ICU did reveal significantly higher mortality rate(65%) with regard to probable leptospirosis. 12 It is important to delineate the causes for the above variation. It is possible that genetic and virulence or serotype related factors may contribute towards high mortality noted in both studies from Sri Lanka in comparison with similar studies from Asian, South American and European series.…”

Section: Discussionmentioning

confidence: 99%

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Determinants of mortality and impact of therapy in patients with leptospirosis admitted for intensive care in a Sri Lankan hospital – a three year retrospective study

Weeratunga

Fernando

Sriharan

et al. 2015

Pathogens and Global Health

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Section: Leptospirosis In Intensive Care Settingsmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Determinants of mortality and impact of therapy in patients with leptospirosis admitted for intensive care in a Sri Lankan hospital – a three year retrospective study

Weeratunga

Fernando

Sriharan

et al. 2015

Pathogens and Global Health

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“…This is similar to the nding of Weeratunga, Fernando [75] who showed the presence of MODs was independently associated with the mortality. In a similar manner, another study found that mortality is increased with increased the number of the dysfunctional systems and critical care management at three organ involvement stage would improve the outcome of the patients [96].…”

Section: Discussionmentioning

confidence: 69%

Determinants of prolonged hospitalization and mortality among leptospirosis patients attending tertiary care hospitals in northeastern state in Peninsular Malaysia: A cross sectional retrospective analysis

Hariri¹,

Sulaiman²,

Khan³

et al. 2021

Preprint

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Objectives Leptospirosis is the most common anthropozoonosis worldwide and imposes a major public health problem in many tropical countries. It is a leading cause of disease burden in form of mortality, morbidity and hospital admission. Identifying patients at high risk for mortality or for prolonged hospitalization may save lives and preserve economy. The aim of the current study was to identify significant factors associated with disease mortality and prolonged hospitalization.Design Cress-sectional retrospective studySettings Tertiary care teaching hospitals in Kelantan, Peninsular Malaysia Participants Adult patients proven to have leptospirosis depending on IgM ELISA were classified into two classes depending on prolonged hospitalization (>7 days or ≤ 7 days) and mortality (fatal cases or non-fatal cases). Patients’ clinico-laboratory data were compared according to these two outcomes using the appropriate statistical test accordingly.Results Of the 525 patients enrolled, 136 (25.9%) had prolonged hospitalization. The mean length of stay was 6.77 ± 5.68 days. Logistic regression analysis identified acute kidney injury (AKI) (OR 2.3), Jaundice (OR 2.7), elevated alanine aminotransferase (ALT) (OR 2), and prolonged prothrombin time (PT) (OR 1.9) independently associated with prolonged hospitalization. Case fatality rate was 6.48% and around one third of fatal cases had prolonged hospitalization of more than seven days. Factors associated with leptospirosis mortality included age > 40 years (p<0.001), patients presented with tachypnea (p=0.002), pulmonary infiltrate (p<0.001), T-wave changes (p<0.001), atrial fibrillation (p=0.013), conducting abnormality (p<0.001), chronic kidney diseases (p<0.001), multiple organ dysfunctions (p<0.0010), respiratory failure (p<0.001), pneumonia (p<0.001), sepsis (p=0.004), low venous PH (p=0.042), AKI (P<0.001), elevated AST (p<0.001) or ALT (p=0.004), hypoalbuminemia (p<0.001), rhabdomyolysis (p<0.001), severe thrombocytopenia (p=0.042), prolonged PT (p<0.001) or prolonged aPTT (p<0.017).Conclusions Significant proportion of leptospirosis patients (25.9%) had prolonged hospital stay and less proportion died (6.48%). Early identifying patients with factors associated with prolonged hospitalization and death will positively impact practitioners’ decisions regarding the proper and fast course of management including ICU admission

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“…This is similar to another finding by Weeratunga et al who showed the presence of MODs was independently associated with the mortality. In a similar manner, another study found that mortality was increased with increased the number of the dysfunctional systems and critical care management at three organ involvement stage would improve the outcome of the patients (92).…”

Section: Discussionmentioning

confidence: 71%

Determinants of prolonged hospitalization and mortality among leptospirosis patients attending tertiary care hospitals in northeastern state in peninsular Malaysia: A cross sectional retrospective analysis

et al. 2022

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BackgroundLeptospirosis is the most common anthropozoonosis worldwide and imposes a major public health problem in many tropical countries. It is a leading cause of disease burden in form of mortality, morbidity and hospital admission. Identifying patients at high risk for mortality or for prolonged hospitalization may save lives and preserve economy. The aim of the current study is to identify significant factors associated with disease mortality and prolonged hospitalization.DesignCress-sectional retrospective study.SettingsTertiary care teaching hospitals in Kelantan, Peninsular Malaysia.ParticipantsAdult patients proven to have leptospirosis depending on IgM ELISA were classified into two classes depending on prolonged hospitalization (>7 days or ≤ 7 days) and mortality (fatal cases or non-fatal cases). Patients' clinico-laboratory data were compared according to these two outcomes using the appropriate statistical test.ResultsOf the 525 patients enrolled, 136 (25.9%) had prolonged hospitalization. The mean length of stay was 6.77 ± 5.68 days. Logistic regression analysis identified acute kidney injury (AKI) (OR 2.3), Jaundice (OR 2.7), elevated alanine aminotransferase (ALT) (OR 2), and prolonged prothrombin time (PT) (OR 1.9) independently associated with prolonged hospitalization. Case fatality rate was 6.48% and around one third of fatal cases had prolonged hospitalization of more than seven days. Factors associated with leptospirosis mortality included age >40 years (p < 0.001), patients presented with tachypnea (p = 0.002), pulmonary infiltrate (p < 0.001), T-wave changes (p < 0.001), atrial fibrillation (p = 0.013), conducting abnormality (p < 0.001), chronic kidney diseases (p < 0.001), multiple organ dysfunctions (p < 0.0010), respiratory failure (p < 0.001), pneumonia (p < 0.001), sepsis (p = 0.004), low venous PH (p = 0.042), AKI (P < 0.001), elevated AST (p < 0.001) or ALT (p = 0.004), hypoalbuminemia (p < 0.001), rhabdomyolysis (p < 0.001), severe thrombocytopenia (p = 0.042), prolonged PT (p < 0.001) or prolonged aPTT (p < 0.017).ConclusionsSignificant proportion of leptospirosis patients (25.9%) had prolonged hospital stay and less proportion died (6.48%). Early identifying patients with factors associated with prolonged hospitalization and death will positively impact practitioners' decisions regarding the proper and fast course of management including ICU admission.

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Severe Leptospirosis - A case series and review

Abstract: BackgroundThe purpose of this retrospective case review was to identify different patterns of clinical presentation of severe leptospirosis, and to find out any correlation between organ specific complication/s and outcome of the patients.

Cited by 5 publications

References 3 publications

Determinants of mortality and impact of therapy in patients with leptospirosis admitted for intensive care in a Sri Lankan hospital – a three year retrospective study

Determinants of mortality and impact of therapy in patients with leptospirosis admitted for intensive care in a Sri Lankan hospital – a three year retrospective study

Determinants of prolonged hospitalization and mortality among leptospirosis patients attending tertiary care hospitals in northeastern state in Peninsular Malaysia: A cross sectional retrospective analysis

Determinants of prolonged hospitalization and mortality among leptospirosis patients attending tertiary care hospitals in northeastern state in peninsular Malaysia: A cross sectional retrospective analysis

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