Leptospirosis with Acute Liver Injury

Wysocki, John; Liu, Yong; Shores, Nathan J.

doi:10.1080/08998280.2014.11929130

Cited by 14 publications

(14 citation statements)

References 7 publications

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“…This results in increased delivery of Na + ions to collecting tubule where epithelial sodium channels reabsorb the Na + ions in exchange for K + ions leading to kaliuresis. 27 Elevation of serum creatinine has been reported in 27-100% patients, 13,[22][23] 41% participants had elevated serum creatinine in our study. The observed difference in prevalence of AKI varies with geographical regions and with different serovars.…”

Section: Discussionsupporting

confidence: 50%

“…Occupational and accidental exposures occur commonly in the low socio-economic strata imposing a financial burden on the destitute. Leptospirosis patients can develop pulmonary haemorrhage, [6][7][8][9][10] acute kidney injury (AKI), 11 pancreatitis 12 and hepatic dysfunction 13 which contribute to mortality and morbidity. The fatality is high with multiorgan involvement especially pulmonary haemorrhage, AKI, and pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

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Serum Electrolytes, Renal, Hepatic and Pancreatic Function in Leptospirosis and Their Association With Its Severity

Jacob¹,

R.V²

2018

jebmh

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BACKGROUND Leptospirosis is an important cause of mortality and morbidity in Kerala. The present study is conducted to evaluate the association of serum electrolytes, parameters of renal, hepatic and pancreatic function with the severity of leptospirosis. MATERIALS AND METHODS We enrolled 84 participants in our descriptive study with leptospirosis aged 18 years or above with leptospirosis admitted under General Medicine in 2 years. Pre-existing renal, hepatic and respiratory diseases were excluded. The study was approved by Institutional Ethics Committee and written informed consent was obtained from all study participants. Serum electrolytes, liver function tests, renal function tests, serum amylase, serum lipase and creatinine phosphokinase were done in central laboratory 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 participants (n=84), 71% were males, 70% had severe leptospirosis, 72.6% had hyponatremia, 23.8% had hypokalaemia, 40.5% had elevated serum creatinine, 65.5% had elevated blood urea, 56% had elevated serum total bilirubin (T.bil) and 31% had elevated direct bilirubin (D.bil). Aspartate Amino transferase (AST), Alanine Aminotransferase (ALT), Alkaline Phosphatase (ALP) and Creatinine Phosphokinase (CPK) were elevated in 61.9%, 47.6%, 44% and 15.5% participants respectively. 8.3% participants had elevated serum amylase and lipase. Significant association with severity of leptospirosis was observed for serum sodium (p=0.

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Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Serum Electrolytes, Renal, Hepatic and Pancreatic Function in Leptospirosis and Their Association With Its Severity

Jacob¹,

R.V²

2018

jebmh

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“…Sometimes it is very difficult to differentiate it from viral hepatitis and viral hemorrhagic fevers but jaundice along with renal involvement and outdoor activities and water exposure are helpful clues. Different complications have been reported which are associated with severe disease and include acute respiratory distress syndrome with alveolar hemorrhage, optic neuritis, uveitis, acute liver injury, gastrointestinal bleed, acute kidney injury required dialysis, peripheral neuropathy and rhabdomyolysis [5][6][7][8][9]. Our patient did not meet all these criteria at same time which would have needed more intensive monitoring.…”

Section: Discussionmentioning

confidence: 89%

Interesting Case of Leptospirosis Presenting as Jaundice and Acute Renal Failure in North East Tennessee

Khan¹,

Khalid²,

Moorman³

et al. 2018

Journal of Microbiology and Infectious Diseases

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Leptospirosis is a worldwide zoonotic infection common in the tropics especially during the hurricanes and floods seasons. Most common clinical presentation is rash, fatigue, weakness, malaise, fever, headache just like viral prodromal symptoms, but clinical presentation of jaundice liver and kidney dysfunction in severe cases can result in multiorgan failure. Diagnosis need serology and cultures which are usually positive early in course of the disease but require special media to grow i.e. Fletcher's media. Treatment is usually with Penicillin or doxycycline. We present a case of leptospirosis presenting with jaundice along with acute liver and renal involvement in the form of Weil's disease which is one of the severe form of presentation. Diagnosis was made by positive leptospirosis serology. Patient was treated with oral doxycycline. Patient had good response to antibiotics with resolution of symptoms on follow up outpatient. J Microbiol Infect Dis 2018; 8(2):80-82.

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“…327 Liver pathology is predominantly a cholestatic hepatitis with reactive hepatocellular changes and Kupffer cell hyperplasia. 283,[327][328][329] Scattered Councilman bodies, bile within canaliculi, and mild portal inflammation may be seen. 283,330 Very rarely, spirochetes can be demonstrated on silver stain.…”

Section: Leptospirosismentioning

confidence: 99%

“…283,330 Very rarely, spirochetes can be demonstrated on silver stain. Immunohistochemical staining for Leptospira is also available from the Centers for Disease Control and Prevention, 328 and PCR assays can be performed from formalin-fixed, paraffin-embedded tissue. 331 However, the diagnosis is usually based on serologic assays.…”

Section: Leptospirosismentioning

confidence: 99%