Human leptospirosis in eastern Croatia, 1969–2003: Epidemiological, clinical, and serological features

Abstract

This survey presents epidemiological, serological and clinical features of 270 patients (85% males, 18% children) treated for leptospirosis from 1969 to 2003 at the Clinic for Infective Diseases, University Hospital Osijek, Osijek, eastern Croatia. 75% of the admissions were between July and October. The route of transmission was mostly by indirect contact with domestic animals, less frequently by direct contact with urine or tissue of infected animals. Clinical presentation included signs and symptoms with expected and common frequency, with the exception of jaundice (62%) and aseptic meningitis (60%), which occurred with higher incidence than previously reported. Acute renal failure ensued in 53% of patients, 7% of whom required haemodialysis. No deaths were observed. Therapy consisted of antimicrobials (penicillin and doxycycline) and symptomatic measures. Diagnosis was confirmed by microscopic agglutination test (MAT). There were in total 18 serological types of Leptospira detected, and types L. sejroe, L.pomona, L. australis and L. icterohaemorrhagiae prevailed. During the last 10 y some new types were observed. Leptospirosis was not rare in the region of eastern Croatia, and its course could be life-threatening if not recognized and adequately treated.

Epizootiological survey of small mammals as Leptospira spp. reservoirs in Eastern Croatia

“…Serogrouping of isolates revealed that 10/20 belong to serogroup Pomona, 6/20 to serogroup Australis, 2/20 to serogroup Sejroe, 1/20 to serogroup Bataviae and 1/20 to serogroup Grippotyphosa. These results correlate to the latest serological surveys on human leptospirosis in Eastern Croatia which reports Pomona, Australis and Sejroe as the most prevalent serogroups (Peric et al, 2005; Cvitkovic, 2007). In this study 9/10 (90.0%) of L. kirschnerii serovar Mozdok serogroup Pomona were isolated from A. agrarius , which confirms this species as natural host of L. interrogans serogroup Pomona (Borcic et al, 1986).…”

Leptospirosis and characterization of Leptospira isolates from patients in Koprivnica-Križevci County, Croatia from 2000–2004

“…Other increased laboratory markers correlated more strongly with severity of clinical presentation of leptospirosis (). Comparative results were found also in other studies [7, 8, 24, 30].…”

“…Seroepidemiological and seroepizootiological studies in Croatia based on the MAT test have shown changes in the incidence of probable infectious serogroup in both animals and humans. Studies show continuous presence of Grippotyphosa and Icterohaemorrhagiae serogroups, reduced frequency of Sejroe (serovar Saxkoebing), and increasing frequency of Australis serogroup [14,16,22,30,31]. In the period of our study, serogroup Icterohaemorrhagiae remained dominant (Table 1).…”

Leptospirosis

“…Es igualmente común la elevación de los niveles de las enzimas musculares, como la creatín-fosfocinasa. En los pacientes con meningitis existe pleocitosis, que inicialmente es polimorfonuclear, pero posteriormente se transforma en mononuclear; la proteinorraquia también suele aumentar, pero la glucorraquia suele ser normal 10 .…”