Leptospirosis-associated disturbances of blood vessels, lungs and hemostasis

Medeiros, Fernanda da Rocha; Spichler, Anne; Athanazio, Daniel Abensur

doi:10.1016/j.actatropica.2010.02.016

Cited by 55 publications

(57 citation statements)

References 64 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1,2 The rate of SPHS (and thus the case-fatality rate) may be increasing in urban Brazil and elsewhere in Latin America [8][9][10] ; thus far, most reported SPHS occurs in adults. 9 In São Paulo, Brazil, SPHS is commonly observed among hospitalized persons, 11 and nearly three-fourths (74%) of patients who die have Weil's syndrome and SPHS.…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Severe Pediatric and Adult Leptospirosis in São Paulo, Brazil

Spichler¹,

Athanazio²,

Vilaça³

et al. 2012

The American Society of Tropical Medicine and Hygiene

Self Cite

View full text Add to dashboard Cite

Abstract. Although leptospirosis may be fatal in childhood, the experience of many clinicians working in diseaseendemic areas is that classic Weil's disease and death are less common among pediatric patients. The aim of the study was to ascertain disease spectrum and outcome differences in severe pediatric and adult leptospirosis in a large at-risk population. Epidemiologic, clinical, and laboratory data were obtained on hospitalized cases from Sã o Paulo during [2004][2005][2006]. A total of 42 case-patients < 18 years of age and 328 case-patients ! 18 years of age were tested during the study. Compared with children, adults had higher rates of jaundice (P = 0.01), elevated serum bilirubin levels (P < 0.01), oliguria (P = 0.02), and elevated creatinine levels (P = 0.01) but not for thrombocytopenia or pulmonary involvement. The overall case-fatality rate was 27% (adult) versus 5% (pediatric) (P < 0.01). Severe pediatric leptospirosis may be less likely to show all classic features of Weil's disease and may be less fatal than in adults.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Severe Pediatric and Adult Leptospirosis in São Paulo, Brazil

Spichler¹,

Athanazio²,

Vilaça³

et al. 2012

The American Society of Tropical Medicine and Hygiene

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most human infections are asymptomatic or cause mild febrile illness that is indistinguishable from diseases caused by other infectious agents. However, 5-10% of human infections will become severe, resulting in the Weil's triad of acute renal failure, hemorrhages, and jaundice (with 5-30% fatality) or severe pulmonary hemorrhagic syndrome (SPHS, with ≥ 50% fatality) (WHO 2003a, McBride et al 2005, Medeiros et al 2010). Non-human primates usually develop a self resolving, mild illness in naturally acquired or experimental infections ( Minette 1966, Minette & Shaffer 1968), but some species may develop severe disease.…”

Section: Introductionmentioning

confidence: 99%

Evidence of leptospiral exposure in neotropical primatesrescued from illegal trade and a Zoo in Bahia, Brazil

et al. 2016

Self Cite

View full text Add to dashboard Cite

Few studies have compared the seroprevalence of antileptospiral agglutinins with the demonstration of urinary shedding of leptospires or evidence of active infection in the bloodstreams of non-human primates. The study population consists of 58 animals, including d 42 monkeys from the Zoological Park of Salvador (Parque Zoobotânico Getúlio Vargas), Bahia, Brazil. The study also evaluated 16 primates (Cebus sp.) rescued from illegal trade that were housed in the Wildlife Rehabilitation Center of Salvador (CETAS), Bahia, Brazil. The seroprevalence of antileptospiral antibodies was low (2%) in the animals from the Zoo. A higher rate (31%) was observed among the animals that were rescued from illegal trade in the state of Bahia. Even if all the blood and urine samples were negative for leptospiral DNA fragments, the high frequency of serological evidence of exposure suggests a potential risk of leptospirosis transmission when keeping these animals as pets.INDEX TERMS: Leptospirosis, Leptospira, Primates.rEsUMO.-[Indícios de exposição a leptospiras em primatas neotropicais resgatados do comércio ilegal e de um Zoológico da Bahia.] Poucos estudos compararam a soroprevalência de aglutininas antileptospira com a demonstração de excreção urinária de leptospiras ou evidên-cia de infecção ativa em primatas não humanos. A população estudada consistiu em 58 animais, sendo 42 primatas do Parque Zoobotânico Getúlio Vargas, Bahia, Brasil. O estudo avaliou ainda 16 primatas (Cebus sp.) resgatados do tráfico ilegal e abrigados no Centro de Triagem de Animais Silvestres Chico Mendes, Salvador, Bahia, Brasil. A soroprevalên-cia de anticorpos antileptospira foi baixa (2%) nos animais do Zoológico. Uma taxa mais elevada (31%) foi observada nos animais resgatados do tráfico ilegal. Mesmo que todas as amostras de sangue e urina tenham sido negativas para DNA de leptospiras, a alta frequência de evidência de exposição nos animais de origem selvagem indicam o risco potencial da adoção de primatas como animais de estimação.

show abstract

“…A brief afebrile period may follow this phase just before the immune phase of the disease begins. The latter is characterized by multiorgan involvement and a higher mortality rate 2,3,5,6 . Less common presentations may occur in a significant number of cases and lead to misdiagnosis.…”

mentioning

confidence: 99%

“…Most patients will present a febrile self-limited condition, often misdiagnosed as influenza or dengue 1,2,4 . Severe manifestations occur in approximately 5-10% of human infections and are characterized by the presence of jaundice, acute renal failure and hemorrhagic disorders, including severe pulmonary hemorrhage syndrome 1,2,5 . In severe forms the biphasic presentation becomes more evident.…”

mentioning

confidence: 99%

“…Less common presentations may occur in a significant number of cases and lead to misdiagnosis. Pulmonary involvement may range from clinically undetectable to massive hemoptysis and respiratory failure, with severe pulmonary forms present in up to 74% of lethal cases, representing the main cause of death in Brazil 2,5 . Neurological manifestations such as symptomatic aseptic meningitis, myeloradiculopathy and myelopathy may be found in case-reports throughout the literature 4 .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Atrial flutter complicating severe leptospirosis: a case report

Silva

Benevides

et al. 2013

Rev. Soc. Bras. Med. Trop.

View full text Add to dashboard Cite

Cardiac disturbances are relatively common and electrocardiographic abnormalities may be found in more than 70% of patients with leptospirosis. We report the case of a 68 year-old male with severe leptospirosis who developed atrial flutter. Effective treatment was done with amiodarone. The patient became clinical stable, with complete recovery. Rigorous clinical observation and continuous electrocardiogram (ECG) monitoring may facilitate the identification of rhythm disorders, and thus prevent a probable fatal outcome, in severe cases of leptospirosis.

show abstract

Leptospirosis-associated disturbances of blood vessels, lungs and hemostasis

Cited by 55 publications

References 64 publications

Comparative Analysis of Severe Pediatric and Adult Leptospirosis in São Paulo, Brazil

Comparative Analysis of Severe Pediatric and Adult Leptospirosis in São Paulo, Brazil

Evidence of leptospiral exposure in neotropical primatesrescued from illegal trade and a Zoo in Bahia, Brazil

Atrial flutter complicating severe leptospirosis: a case report

Contact Info

Product

Resources

About