Leptospirosis: The "mysterious" mimic (original) (raw)

Leptospirosis: A Neglected Zoonosis of Public Health Concern

Leptospirosis is an important emerging and re-emerging zoonotic disease that is spread worldwide by pathogenic species of the bacterium genus Leptospira. The disease is commonly reported especially in tropical and subtropical areas. Leptospirosis is a neglected tropical zoonotic disease that is rapidly becoming a major public health issue around the world. Leptospirosis has emerged as a prominent cause of acute febrile disease in many developing nations due to neglect, rapid, unplanned urbanization, and poor sanitation. Although it has been stated that leptospirosis is the most frequent zoonotic illness, it is thought to be underreported due to the non-specificity of clinical symptoms and the lack of laboratory confirmation in endemic areas. A wide range of clinical manifestations, ranging from asymptomatic infection to fulminant, deadly disease, is characteristic of the disease. Laboratory help is needed to confirm an unequivocal diagnosis of leptospirosis. Antibacterial antibiotics are used to treat the acute illness in the patient. This mini review includes all current information on leptospirosis, including its etiology, transmission, clinical symptoms, diagnosis, treatment, and preventative measures.

Varied presentations of leptospirosis: experience from a tertiary care hospital in north India

Leptospirosis has been recognised as an emerging global public health problem. The aim of our study was to explore the epidemiological and clinical pattern of disease occurrence in suspected cases and to search for any existing co-infections. Ours was a retrospective study in patients with acute febrile illness in north India over a period of three years (April 2011 to June 2014). Serological diagnosis of leptospirosis was made using the PanBio IgM ELISA kit. Using modified Faine's criteria, presumptive and possible diagnosis was made in 57% and 34% cases, respectively. Most of the affected population was resident in north and central India. Nineteen patients showed co-infection with other common pathogens prevailing locally. There is a need to increase awareness and understand the local sero-epidemiological pattern of leptospirosis so that timely preventive and curative action may be taken by healthcare authorities.

Leptospirosis: an emerging global public health problem

Journal of biosciences, 2008

Leptospirosis has been recognized as an emerging global public health problem because of its increasing incidence in both developing and developed countries. A number of leptospirosis outbreaks have occurred in the past few years in various places such as Nicaragua, Brazil and India. Some of these resulted due to natural calamities such as cyclone and fl oods. It is a direct zoonotic disease caused by spirochetes belonging to different pathogenic species of the genus Leptospira. Large number of animals acts as carriers or vectors. Human infection results from accidental contact with carrier animals or environment contaminated with leptospires. The primary source of leptospires is the excretor animal, from whose renal tubules leptospires are excreted into the environment with the animal urine. Majority of leptospiral infections are either sub clinical or result in very mild illness and recover without any complications. However, a small proportion develops various complications due to involvement of multiple organ systems. In such patients, the clinical presentation depends upon the predominant organs involved and the case fatality ratio could be about 40% or more. Febrile illness with icterus, splenomegaly and nephritis (known as Weil's disease), acute febrile illness with severe muscle pain, febrile illness with pulmonary haemorrhages in the form of haemoptysis, jaundice with pulmonary haemorrhages, jaundice with heamaturea, meningitis with haemorrhages including sub conjunctival haemorrhage or febrile illness with cardiac arrhythmias with or without haemorrhages are some of the syndromes. Because of the protean manifestations of leptospirosis it is often misdiagnosed and under-reported. Although the basic principles of prevention such as source reduction, environmental sanitation, more hygienic work-related and personal practices etc., are same everywhere, there is no universal control method applicable to all epidemiological settings. Comprehensive understanding of the eco-epidemiological and cultural characteristics of a community that faces the problem of leptospirosis is an essential prerequisite for evolving an effective and acceptable control measure.

An outbreak of leptospirosis in Mumbai

Following prolonged water logging due to heavy rainfall in Mumbai during July 2000, a total of 102 patients clinically suspected of leptospirosis were admitted in our hospital. Blood samples were examined for the presence of leptospires by dark ground microscopy (DGM) and IgM antibodies were detected by ELISA. Out of 102 blood samples, 37 were positive by ELISA giving a positivity rate of 36.27%. Of these, only 24 were positive by DGM. Out of the positive cases, 37.83% had respiratory symptoms, 32.43% each had jaundice and conjunctival suffusion and 16.21% had renal involvement. Mortality amongst the positive cases was 10.81%. Apart from hepatic and renal involvement, respiratory symptoms due to leptospirosis are on the rise.

Leptospirosis in Kolkata- a Retrospective Study Over Eight Years in a Medical College and Hospital

Journal of Evolution of Medical and Dental Sciences, 2017

BACKGROUND Leptospirosis is a bacterial infectious disease that affects humans and animals. It is caused by pathogenic spirochetes of the genus Leptospira. It is a specific zoonotic disease with worldwide distribution with a much greater incidence in tropical countries like India. In West Bengal, especially in Kolkata, there is high average rainfall with water holding capacity of soil. Also, there is a huge natural population of rodents and stray dogs which serve as the carrier of the disease. The sanitary arrangements for the roadside slaughtering houses are very poor. In the rainy season, parts of the city remain waterlogged. The above points are the sole reasons for the cases of leptospirosis in the city of Kolkata. There were considerable good number of cases from the surrounding areas.

Clinical profile and outcome of leptospirosis at tertiary care centre in western Maharashtra

Journal of Academy of Medical Sciences, 2012

Background: Leptospirosis is an emerging spirochetal zoonosis world wide. Leptospirosis is common zoonosis that is under reported and under diagnosed in India. The aim of this study was to study the clinical profile outcome and prognostic factors in human leptospirosis at tertiary care centre. settings and design: This was a retrospective study of leptospira positive patients who were admitted in tertiary care centre. The study was conducted in 2010, over a period of 6 month from July to December. Materials and Methods: All patients who presented with clinical features and tested IgM positive for leptospirosis were taken into the study and analyzed based on modified Faine's criteria. results: Out of total 23 patients there were 21 males and 2 females, with mean age was 32 years. Maximum incidence of cases was found in month of July and August. Out of total 23 patients, 18 (78.26%) were farmers and 5 (21.73%) were laborers. Predominant complaints were fever, jaundice, myalgia, and headache. All 23 had positive results for IgM against leptospira. Liver function tests were deranged in 16 (69.56%) and renal functions were deranged in 12 (52.17%). Total 7 (30.43%) patients had Weil's syndrome and 7 (30.43%) had acute respiratory distress syndrome (ARDS). Total 7 (30.43%) patients had neuroleptospirosis, out of which 5 (21.73%) had aseptic meningitis, one had paraparesis secondary to lumbar radiculopathy and one had meningoencephalitis. Hyperkalemia was present in 6 (26.08%) patients, 7 (30.43%) patients had hypokalemia. Total 11 (47.82%) patients had metabolic acidosis (pH<7.3) on arterial blood gas analysis. Two (8.69%) patients had disseminated intravascular coagulation and 3 (13.04%) patients had thrombocytopenia. There was one death due to meningoencephalitis with multiorgan failure with overall case fatality rate of 4.34%. Total nine patients with oliguric renal failure were treated with daily dialysis and seven patients with ARDS were on artificial ventilator. Applying modified Faine's criteria, all 23 were positive for leptospirosis. All patients responded ceftriaxone. conclusions: Leptospirosis was unexpectedly found to be positive in many of our patients who were having pyrexia with multiorgan dysfunction during the monsoons. Hepatic dysfunction, acute renal failure, ARDS, and neuroleptospirosis in decreasing frequency were the commonest complication. Daily dialysis, ventilatory support and intensive care management has definitely reduced morbidity and mortality associated with leptospirosis with multi-organ failure.