Clinical presentation of leptospirosis: a retrospective study of 34 patients admitted to a single institution in metropolitan France

Abstract

Leptospirosis has a highly variable clinical presentation, which may be related to different infecting serovars, host factors, or a combination of these. This study investigated retrospectively 34 consecutive patients with serologically confirmed leptospirosis admitted during the period 1992-2002. On admission, the most frequent symptoms were fever (100%), headache (75%), myalgia (55%), arthralgia (45%) and vomiting (39%). Pertinent laboratory findings included lymphopenia (85%), thrombocytopenia (75%), elevated liver enzymes (87%) and renal abnormalities (proteinuria, 77%; haematuria, 58%; elevated serum creatinine, 53%). The study confirmed the variable clinical and biological symptoms of leptospirosis, and indicated that lymphopenia is a common feature of leptospirosis cases.

Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil

“…Jauréguiberry et al 19 found AST and ALT levels higher than 40 IU⁄ L in 83 and 86%, respectively. In a study with 72 patients from Turkey with confirmed diagnosis of leptospirosis the mean AST and ALT levels were higher in nonsurvivors than in survivors.…”

“…Andrade et al 20 identified the serovars Icterohaemorrhagiae and Copenhageni in 71% and 18% of patients, respectively. Jauréguiberry et al, 19 studying 34 patients, identified the serovars Grippotyphosa (30%), Icterohaemorrhagiae (15%) and Copenhageni (12%). Ko et al 3 found Leptospira interrogans serovar Copenhageni in 87% of the cases with positive blood cultures of patients with severe leptospirosis.…”

“…9,11,15,17 The disease is more common among young people, as confirmed in the present study. 9,11,16,19 The cases described here represent the severe end of the spectrum of leptospirosis. The availability of laboratory diagnostic tests would probably reveal many more cases, most of them anicteric.…”

“…These are the most common findings reported in leptospirosis. 1,7,8,9,17,19 Hemorrhagic manifestations are characteristic of Weil disease, and are potentially fatal. Patients can develop important hemodynamic abnormalities, secondary to hypovolemia, which is caused by dehydration and direct effects of Leptospira toxins that damages vascular endothelium and increases permeability.…”

“…Leptospirosis is also related to recreational activities. 4,19 It is important to identify the serovars associated with human infections by leptospires. Andrade et al 20 identified the serovars Icterohaemorrhagiae and Copenhageni in 71% and 18% of patients, respectively.…”