COMPLETE BLOOD COUNT, IgM AND URINE ROUTINE IN LEPTOSPIROSIS AND THEIR ASSOCIATION WITH SEVERITY IN AN ENDEMIC AREA

Abstract

BACKGROUND Leptospirosis is an important cause of mortality and morbidity in India. The present study is conducted to evaluate the association of various blood parameters and urinary parameters with the severity of leptospirosis. MATERIALS AND METHODS Our descriptive study enrolled 84 participants with leptospirosis aged 18 years or above admitted under General Medicine in a period of 2 years. Participants with pre-existing renal, hepatic and respiratory diseases were excluded. Study was approved by Institutional Ethics Committee and written informed consent was obtained from all study participants. All investigations were done in the central laboratory of the institution and results were analysed using R®. Parameters are expressed as categorical variables and association was determined using Chi-square test and Fischer's exact test and p <0.05 was considered statistically significant. RESULTS Among the study participants, 71% were males and 70% had severe leptospirosis. 72% participants had normal leukocyte count, 70% participants had neutrophilia and 32% participants had lymphocytosis. 66% had thrombocytopenia and 2.4% participants had platelet count less than 10,000 cells/μL. 89% participants had elevated erythrocyte sedimentation rate (ESR). 23.8% participants had more than 5 pus cells in urine and 69% had granular cast in urine. Significant association was observed with severity of leptospirosis for platelet count (p<0.001), ESR (p=0.01; OR: 5.9, 95% CI: 1.3-25.9), pyuria (p=0.03; OR: 5, 95% CI 1.1-23.7) and granular cast in urine (p<0.001; OR: 0.6, 95% CI 0.4-0.7). CONCLUSION Early diagnosis, monitoring of clinical and laboratory parameters and prompt intervention in terms supportive care and antibiotic therapy will help in reducing morbidity and mortality.