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PubMed1989

Central nervous system leptospirosis in the Philippines.

One hundred hospitalized patients in Manila, Philippines with aseptic meningoencephalitis were screened for leptospirosis. On the basis of a microscopic agglutination titer of 1:1,600 or greater, the diagnosis was made in five cases, yet in no instance had leptospirosis been included in the differential diagnosis on admission to the hospital. Four of the five patients first noted neurologic symptoms during the second week of illness; two patients presented with encephalitis, two with meningitis and the fifth with hemiparesis. No case was complicated by renal dysfunction or jaundice. By the time of discharge from the hospital, two patients had recovered completely and the other three had markedly improved. Our data show that leptospirosis is an important but overlooked cause of aseptic meningoencephalitis in the Philippines. This is probably also the case in other parts of the tropics where Leptospira interrogans infection remains a significant public health problem.

Adult↗
PubMed1989

Leptospirosis in piggery workers on Trinidad.

Of 133 cases of human leptospirosis recorded in Trinidad between 1977 and the end of February 1982, at least eight (6%) were in people who worked on pig farms. Three of the eight died, and their presumptive infecting serogroups were Icterohaemorrhagiae (3), Canicola (2), Pyrogenes (2) and Grippotyphosa (1). Six of the eight cases were followed up. Altogether, sera from 201 pigs, 78 other livestock animals, 38 workers and 34 dogs were tested for leptospiral agglutinins. The seropositivity prevalence among pigs on farms with human illness (43% greater than or equal to 1:100) was similar to that in pigs from farms not associated with illness (46%), but the titres among the former group (geometric mean 209.5) were higher than among the latter (91.5), where only titres less than or equal to 1:400 were recorded. Similar infecting serogroups were recorded among pigs on the two groups of farms, with Icterohaemorrhagiae, Autumnalis, Canicola and Pyrogenes most frequently recorded overall. There was little evidence of the pig-adapted serogroups Pomona and Tarassovi. Twelve of 13 workers (93%) from a farm on which at least two other people had contracted leptospirosis had serological evidence of exposure, compared with seven of 24 (29%) on a neighbouring farm not associated with human illness. Dogs and rodents are thought to be the major sources of leptospirosis in pigs and piggery workers in Trinidad.

Adolescent↗
PubMed1989

[Recent clinical findings in leptospirosis].

Forty-four patients admitted 1978-1986 were examined which suffered from leptospirosis. The authors bring a new contribution on the clinic of leptospirosis. They confirm that leptospirosis often assumes a polymorphic clinical degree. They stress the importance of an early diagnosis.

Diagnosis, Differential↗
PubMed1989

[Results of ambulatory care and serodiagnosis of leptospirosis in reconvalescents in the Kuban region].

The importance of the medical checkup of leptospirosis reconvalscents is shown. In 18.9% of persons having had leptospirosis and placed under medical surveillance the presence of pathological changes has been established after clinical convalescence. Recommendations concerning the prolongation of the period of medical surveillance on leptospirosis reconvalescents with less frequent checkups are given.

Adolescent↗
PubMed1979

Leptospirosis in meat inspectors: preliminary results of a serological survey.

A serological survey of leptospirosis among more than 1000 meat inspectors, from meat works throughout New Zealand, revealed a serological prevalence at a minimum serum dilution of 1:24, of 10.2 percent. Eighty-five percent of serological reactions were to serovars pomona and tarassovi. A highly significant correlation was demonstrated between the serological prevalence of these serovars and the inspection of pigs. Evidence is provided to substantiate the use of titres as low as 1:24 as an indication of previous leptospiral infection. Forty-two inspectors reported medical evidence of previous clinical infection with leptospirosis. Analysis of those who still exhibited a serological response and their individual case histories, indicated that detectable titres of leptospirosis can exist for up to 10 years.

Animals↗
PubMed1985

[Demonstration of lipoprotein anomalies in leptospirosis. Prospective study in 10 patients].

Abnormalities of lipid metabolism have never been shown in human leptospirosis. A prospective study of plasma lipids was performed in 10 consecutive patients with leptospirosis. Significant increase of triglycerides with low levels of the high-density lipoproteins and cholesterol fraction was observed in 8 patients. Electrophoresis of lipoproteins showed a fusion of beta and pre-beta lipoproteins and a marked decrease of alpha lipoproteins. The respective role of bacteria, liver and kidney could be suggested to explain these abnormalities of lipoproteins in leptospirosis.

Adolescent↗
PubMed1985

Comparative study of four saprophytic leptospira strains as screening antigens in the serodiagnosis of leptospirosis in water buffaloes (Bubalus bubalis).

The profitability of four saprophytic leptospira strains (Buenos Aires, Patoc 1, Rufino and São Paulo) as polyvalent antigen in the serodiagnosis of leptospirosis in water buffaloes was studied by the microscopic agglutination test. From 104 examined sera tested against 16 pathogenic leptospira serotypes, 52 were positives and 52 were negatives. The results led to the conclusion that from four studied strains, Buenos Aires strain showed the best results when utilized in screening tests for the serodiagnosis of leptospirosis in water buffaloes. The other three strains showed a good specificity but their sensibilities were poor and therefore should not be recommended for diagnosing water buffalo leptospirosis.

Animals↗
PubMed1970

Correlation of bedrock type with the geography of leptospirosis.

Leptospirosis occurs enzootically over most of Southern Ontario. Leptospira pomona is the serotype most commonly found in outbreaks. Antibodies to L. pomona occur frequently in the sera of deer in wilderness areas. The geographic location of leptospirosis presents a pattern which closely parallels the distribution of Paleozoic bedrock. By contrast, L. pomona infection is absent from areas underlain by Precambrian bedrock. Comparisons of water chemistry, soil type, habitat, and host and pathogen availability in these two geologically distinct environments have not defined the mechanisms involved in the disease pattern. Leptospires resembling saphophytic strains occur widely, regardless of bedrock type. High titers to L. biflexa, a saprophytic serotype, were found frequently in deer sera from a Precambrian area which was surveyed intensively. Antibodies to L. hardjo and L. sejroe occur in many bovine sera from a predominantly Precambrian area where Paleozoic outliers are numerous. Colloidal clay is common to leptospiral habitats. A microenvironment structured by the surface activity of clay is likely to be a key ecological factor in the landscape epizootiology of leptospirosis. In Ontario, bedrock composed of limestone and dolomite formed in the Paleozoic era appears to be a reliable ecological marker for Leptospira pomona infection.

Animal Diseases↗
PubMed1979

Leptospirosis in the city of Salvador, Bahia, Brazil: a case-control seroepidemiologic study.

From January 1 to December 31 of 1975, all patients admitted to Salvador's Infectious Disease Hospital were serologically tested for leptospirosis if their clinical and laboratory findings were compatible with this diagnosis. Of the 888 patients tested, 133 were positive. Among patients with an initial clinical impression of leptospirosis, the diagnosis was confirmed serologically in 36% and for the 133 leptospirosis patients, only 67 (50.4%) were initially suspected. Epidemiological aspects investigated covered: age, sex, place of residence and occupation for all cases and for fatal cases; distribution of cases by month of occurrence and by rainfall in that month; distribution of serotypes by month; and probable source of infection with emphasis of the occurrence and type of contact with dogs. For each case residing in Salvador, a control of the same age and sex was interviewed in the immediate neighborhood. Sewage, rats, water, dogs, mud and garbage were identified as the most likely source of infection in that order. Marked seasonal fluctuations were apparent with peak incidence during the months of maximum precipitation. In two-thirds of cases reporting contact with a dog, tests on the animal revealed the same serotype. The most frequent serotypes were: icterohemorrhagiae, autumnalis, castellonis, grippotyphosa, hebdomadis and bataviae.

Adolescent↗
PubMed1983

Leptospirosis--an occupational disease of soldiers.

Two cases of leptospirosis are described in soldiers who fell into a river together. One developed Weil's disease due to icterohaemorrhagiae serogroup and the other "Mud-Fever" due to grippotyphosa serogroup. The organisms were initially cultured in standard blood culture media. There were six cases of leptospirosis in BAOR in the 10 years to 1980 giving an incidence 10 times greater than in the civil population of UK and West Germany. Leptospirosis is an occupational disease of soldiers in BAOR and the health risks of fresh water immersion should be publicised.

Adult↗
PubMed1981

A minireview of the pathogenesis of acute leptospirosis.

Hemorrhagic diathesis is one of the most striking manifestations in acute leptospirosis. Hemorrhages are seen in infections due to Leptospira icterohaemorrhagiae as well as in those caused by Leptospira pomona. Thrombocytopenia is a constant feature and its finding can be useful for the diagnosis. Attempts to demonstrate the presence of a toxin in leptospires were unsuccessful. A few years ago, a syndrome of disseminated intravascular coagulation was associated with the physiopathogenesis of experimental leptospirosis with L. icterohaemorrhagiae. More recently, this syndrome was identified in cases of human leptospirosis and in hamsters infected with L. pomona. It appears now that other spirochetal infections (borreliosis) have a similar pathogenesis. Nonetheless, many points are still unclear: the primary cause of disseminated intravascular coagulation is unknown, as well as the virulence factors of spirochetes. Some points favor the presence of a toxic factor in leptospires: vascular damage that occurs in the absence of leptospires in damaged areas and the fact that antibiotic therapy is ineffective unless treatment is initiated early in the disease.

Acute Disease↗
PubMed1981

Urinary excretion of an unidentified treponeme in a case of leptospirosis.

Two kinds of spirochetes were observed by dark-field microscopy in the urine of a leptospirosis patient on day 26 after the onset of the disease. The spirochetes were identified as treponemes and leptospires. A classification of the treponemes on basis of their morphology was attempted by means of electron microscopy with no conclusive result. Cultivation of the spirochetes was unsuccessful. Sera obtained prior to, during and after the excretion of spirochetes were tested for antibodies in routine serology tests for leptospirosis and syphilis. The diagnosis leptospirosis was confirmed by a rise and subsequent fall in antibody titres. The sera were nonreactive in syphilis serology tests, but showed a weak fluorescence in a fluorescent treponemal antibody absorption (FTA-ABS) test when Treponema calligyrum was used as antigen. It could not be determined whether this reaction was due to antibodies raised in response to antigens of the excreted treponemes.

Adolescent↗
PubMed1980

Human leptospirosis in Detroit and the role of rats as chronic carriers.

Human leptospirosis was diagnosed in three patients from Detroit General Hospital. Epidemiological studies of these cases revealed heavy rat infestations in the residences of two of the patients. Leptospires serotype icterohaemorrhagiae were isolated from the rats and one of the patients. Cultural isolation was attempted from numerous blood and urine samples from each patient. Media containing different selective contaminant inhibitor substances was also utilized. Only two samples were culturally positive. It appears that very few viable cells are shed by human patients intermittently. Clinical reports and leptospirosis diagnosis are reported for each of the cases. The agglutinin-absortion test proved to be helpful in elucidating the true etiologic agent in the absence of cultural isolation. A serological survey for leptospirosis was conducted among swine slaughterhouse workers in Detroit. Significant titres to Leptospira pomona were observed.

Animals↗
PubMed1995

[Leptospirosis and pregnancy. Eleven cases in French Guyana].

The incidence of leptospirosis, a widespread antropozoonosis, is underestimated due to variable clinical presentations. The abortive effect of this disease, well known in animals, is only reported rarely in humans although transplacental transmission has been demonstrated. We report 11 cases of leptospirosis in pregnant women in French Guiana. The diagnosis was made on identification of the germ in maternal urine samples and/or on specific serology tests. Fetal death occurred in more than 50% of the cases due to premature abortion or in utero death. The rate of maternal-fetal transmissions is not known, but leptospirosis could be a not uncommon cause of perinatal deaths in endemic zones.

Female↗
PubMedDate not supplied

[Leptospirosis in Gastroenterology. Study of 14 cases in the Hospital Universitário de Caracas 1984-1994].

14 cases that were admitted to the Hospital Universitario de Caracas, between 1.989 and 1.994, with a definitive diagnosis of Leptospirosis by microaglutination of live antigens were studied. Most of them hospitalized at the gastroenterology service. The serovar most frequently found was icterohemorragiae 11 cases. There was a predominium for the male gender 12/2 and the majority of patients belonged to the range of age between 31 and 40. The most common forms of presentations were: fever (14), jaundice (10) and myalgias (10) while the most relevant findings at physical examination were: jaundice (12), fever (11) and hepatomegaly (8). All patients had abnormal laboratory tests and among these, aminotransferases, bilirrubin, creatinin, CPK, platelets and urinary sediment were more frequently altered. Only half of the patients were diagnosed as Leptospirosis at the moment of admission. We conclude that even though Leptospirosis is an infectious disease distributed worldwide only few cases are hospitalized and differential diagnosis is difficult because of diversity of clinical presentations and lack of laboratory resources. It is important for gastroenterologists because most of complicated cases present as jaundiced patients.

Adult↗
PubMed1996

[Leptospirosis: a cause of pseudo-malarial fever in Gabon].

A first case of leptospirosis has been recently described in Gabon where bioclimatological characteristics could favour the transmission of that disease. Therefore, a search for antibodies to leptospirae was conducted among 55 military Frenchmen with unexplained fever during a four-month stay in Gabon. Three (5.5%) were positive with IgM levels attesting for recent contamination. A screening antigenic battery identified L. bataviae in two cases and L. sejroe in one case. The three patients were employed outside in the precedent weeks. Travelers are exposed to leptospirosis in numerous Third-World countries. Clinical and biological similarities between leptospirosis and P. falciparum malaria could induce misdiagnosis. Co-infection could also be encountered. Doxycycline, whose activity against P. falciparum is well known, is also effective against leptospirae. Therefore, this drug seems valuable for prophylactic and therapeutic actions in areas exposed to the both diseases.

Adolescent↗
PubMed1996

[Systemic leptospirosis as a cause of multiple organ failure. Report of a case].

Leptospirosis is a world-spread zoonosis that is incidentally acquired by humans. It causes a diphasic febrile illness in which the Weil syndrome is its severest form, with renal, hepatic, clotting and central nervous system involvement. We report a 73 years old male, that was admitted to an intensive care unit with multiple organ failure due to leptospirosis. The clinical picture initially resembled a sepsis due to biliary tract obstruction and was operated, not finding a biliary tract obstruction. Considering the history of a fall to sewed waters, leptospirosis was suspected and treatment with penicillin was started, obtaining a full recovery of the patient.

Abdominal Pain↗
PubMedDate not supplied

Cardiovascular involvement in leptospirosis.

Cardiovascular involvement was studied in 50 patients with serologically proved leptospirosis. Twelve (24%) patients had dyspnoea and 18 (36%) had transient hypotension during the illness. None of them had cardiac enlargement, development of new murmur or pericardial rub. Various electrocardiographic abnormalities occurred in 70 percent of patients. Atrial fibrillation was the most common major arrhythmia (14%). Conduction system abnormalities were seen in 36 percent of patients. T-wave changes were observed in 30 percent of patients. Left ventricular function as assessed by echocardiography and Doppler examination was normal. Three (6%) patients died due to renal failure. In conclusion, even though ECG abnormalities were frequently seen in leptospirosis, there was no data to support associated left ventricular dysfunction. Dyspnoea and hypotension occurring in patients of leptospirosis must be due to a noncardiac mechanism.

Atrial Fibrillation↗