A Systematic Review of the Mortality from Untreated Leptospirosis (original) (raw)
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Transactions of the Royal Society of Tropical Medicine and Hygiene, 2014
Leptospirosis has a mortality rate of 5-20%. Poor prognostic factors are older age; oliguria; elevated potassium, creatinine and/or bilirubin levels; and altered mental status. We conducted this retrospective study to analyse the predictors of mortality among Indian patients with leptospirosis. Clinical, biochemical, demographic and treatment related data (time between onset of symptoms and commencement of leptospira specific antibiotics) of 101 leptospirosis patients were reviewed. Predictors identified by univariate analysis were analysed by multivariable Cox regression for survival analysis. Prominent clinical features were: fever (101/101, 100%), jaundice (62, 62.4%), vomiting (42, 41.6%), oliguria (35, 34.7%), cough (18, 17.8%) and dyspnoea (10, 10.0%). Common complications were acute kidney injury (22, 21.8%), cardiovascular collapse (13, 12.9%), haemorrhages (10, 10.0%), meningitis (7, 6.9%), acute respiratory distress syndrome and pancreatitis (5, 5.0% each). Seventeen patie...
Clinical Profile of Patients of Leptospirosis and Its Outcome
Journal of Advanced Research in Medicine, 2020
Background: Leptospirosis is an emerging spirochetal zoonosis worldwide. It is underreported and under diagnosed in India. The clinical manifestations of Leptospirosis range from an asymptomatic illness, self-limiting systemic infection to severe and potentially fatal disease. Approximately 1 million severe cases occur per year. Aims and Objectives: To study the clinical profile of acute onset fever (less than 7 days) that are IgM positive for leptospira and to study their in hospital outcome. Methods: This observational study was conducted in Dr. Hedgewar Hospital, Aurangabad, Maharashtra. The IgM positive leptospirosis patients admitted during January 2014 to December 2018 were included in the study. The information on demographic and clinical profile of these patients was recorded and analyzed based on modified Faine's criteria. Their in hospital outcome was assessed. Result: The study included 62 leptospirosis IgM positive patients. The mean age was 38.14±15.84 years. All patients presented with fever. Acute Respiratory Distress Syndrome (ARDS) was the most common complication seen in 48.38%. Case Fatality Rate (CFR) was found to be 16.12% (10 out of 62) patients. Conclusion • High proportion of cases indirectly reflects the endemic nature of the disease. • The clinical presentation of leptospirosis is highly protean and may vary from sub-clinical to mild illness to life-threatening complications and death.
PLoS ONE, 2013
Background: Leptospirosis is a global zoonotic disease. Although important for the assessment of the burden of leptospirosis, data on the duration of the illness and the occurrence of post-leptospirosis complaints are not well documented. Hence the main objective of this study was to estimate the occurrence of persistent complaints and duration of hospital stay in laboratory confirmed leptospirosis patients in the Netherlands during 1985 to 2010. Additionally, several risk factors potentially impacting on the occurrence of post-leptospirosis complaints were investigated.
Prognostic Factors of Leptospirosis Patients in Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Acta Interna: The Journal of Internal Medicine, 2011
Background:. Severe disease can be fatal, although majority of cases are mild and self-limited. Objective: To determine the prognostic factors for leptospirosis that associated with mortality in patients with leptospirosis in Dr. Sardjito General Hospital, Yogyakarta. e conducted a retrospective study of data collected in our hospital between Jan 2010 until May 2011, from whom the diagnosis of leptospirosis was confirmed based on pertinent clinical and epidemiological data and positive serology. Result: Thirty two patients were included in this study, including 29 survivors (90.62%) and 3 non-survivors (9.38%). Of these 32 patients, 26 patients (81.25%) were admitted to the medical ward and 6 patients (18.75 %) were admitted to the ICU. Multivariate logistic regression demonstrated that three factors were independently associated with mortality: higher level of potassium (OR 10.8; CI 1.194-97.728; p<0.01) on admission and neurological dysfunction (altered mentation or seizure) (OR 30; CI 4.367-206.07; p<0.01) Conclusion: The mortality of leptospirosis remains high despite improvements in patients care. In order to improve the early treatment of high-risk patients, these higher levels of potassium on admission and neurological dysfunction, which are associated with mortality, can be used at the time of admission as prognostic factors.
Systematic reviews on leptospirosis
Revista do Instituto de Medicina Tropical de São Paulo, 2000
Objectives: To find the existing clinical evidence on interventions for leptospirosis. The objective is to evaluate the effectiveness and safety of any intervention on leptospirosis through systematic reviews of randomized controlled trials (RCTs).
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.
A Review on Epidemiology, Pathogenesis and Treatment of Leptospirosis
International Journal of Advanced Research, 2021
Leptospirosis is a zoonotic disease, it arises worldwide but it is most frequent in tropical and subtropical zone. It is one of the notifiable and treatable disease. Leptospirosis is a plague caused by species of bacteria called Leptospira the bacteria shed into the nature via urine of infected animals. Rats are the most recurrent source of human sepsis. Rivers are the assumption to be a predominant risk factor for transmission of disease to humans. It possesses an extensive variation of mechanisms that allow them to avoid the host immune system and cause infection. The infection is extremely vast ranging from subclinical to multi organ infection with elevated mortality. It is frequently mild but can be terminal, it is likely to be serious and the serious alignment form known as Weils disease and can easily steer to death. The mingling of renal failure, hemorrhage and jaundice is known as Weils disease. It is the most affection pattern associated with critical leptospirosis. It is a...