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PubMed1994

Effect of immune serum, an antibiotic, and a corticosteroid used alone or in combination on experimental leptospirosis in Mongolian gerbils (Meriones unguiculatus).

We studied the effects of immune sera, an antibiotic, and a corticosteroid used alone or in combination on leptospira infection in Mongolian gerbils (Meriones unguiculatus). The results suggest that the combined used of immune serum and corticosteroid (pledonizoron: PZ) inhibits the effects of serum and the marked effects of antibiotic (procaine penicillin-G: PC-G) on leptospirosis. PZ had no effects and rather shortened the survival period. PZ did not affect the effects of PC-G when used in combination. These results suggest that treatment of leptospirosis with corticosteroids requires special caution.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Human leptospirosis--a review of 50 cases.

Epidemiological and clinical aspects of 50 consecutive patients, 47 adults and three children, hospitalized between 1977 and 1987 for human leptospirosis, were reviewed. 45 (90%) of the patients were from rural regions. 32 (64%) cases occurred in individuals at occupational risk for the infection. 35 (70%) cases were registered in the warm season. The source of infection was known in 34 (68%) cases. Weil's disease was diagnosed in 31 (62%) patients, aseptic meningitis in 12 (24%) and acute unexplained fever in seven (14%). Haemodialysis was required for 11 (35%) patients with Weil's disease. Three (6%) patients died. Cause of death was massive gastrointestinal haemorrhage in two and renal failure in one. Leptospira icterohaemorrhagiae was responsible for 39 (78%) cases, Leptospira canicola for six (12%), Leptospira grippotyphosa for two (4%), and Leptospira australis, Leptospira ballum and Leptospira sejroe, for one case each. A muscle biopsy was performed in six patients and a renal biopsy in three. Focal necrotic muscular changes, with mild mononuclear infiltrate, were found. Pigmented casts in distal convoluted tubules, mild interstitial inflammatory infiltrate and mesangial enlargement of some glomeruli were observed in kidney biopsies. A good knowledge of the protean clinical manifestations of leptospirosis and an accurate laboratory study are required for a correct diagnosis.

Adolescent↗
PubMed1995

Human leptospirosis in Italy, 1986-1993.

In the eight-year period 1986-1993, the Italian National Center for Leptospirosis and the Regional Leptospira Laboratories confirmed 312 cases of clinical leptospirosis by using the microscopic agglutination (MA) assay. The majority of cases was observed in Northern regions of the Country. Cases were reported in all age groups, but were most common in the working-age population. Of 312 cases, 291 (93.3%) occurred among males. The largest number of infections was ascribed to occupational activities (45.8%). The typical leptospiral seasonal course, with a peak during the summer, was observed. Involvement of the liver was the most frequent manifestation. Influenza-like symptoms were the only signs of illness in 11.1% of cases. Anti-leptospira antibodies, cross-reacting with two or more serovars, were found in 28.2% of sera. The most frequent serovar-specific antibodies were those against poi, icterohaemorrhagiae, bratislava, copenhageni and sejroe.

Adolescent↗
PubMed2002

Epidemiological and clinical features of leptospirosis in Israel.

The epidemiology and clinical features of 46 cases of human leptospirosis diagnosed in Israel between 1986 and 1999 were analysed. The median patient age was 37.5 years (range, 16-85 years), and the male/female ratio was 43/3. The most common serogroup found was Leptospira icterohaemorrhagiae. The disease was associated with jaundice in 71% of cases, acute renal failure in 62%, rhabdomyolysis in 52%, pancytopenia in 28%, respiratory failure in 14% and disseminated intravascular coagulation in 5%. Leptospirosis occurs sporadically throughout the year, peaking during the summer months. A shift occurred from predominantly agriculture-related serogroups in the 1970s to urban-related serogroups during the study period reported, with Leptospira icterohaemorrhagiae being the dominant serogroup.

Adolescent↗
PubMed2004

Three cases of leptospirosis requiring intensive care.

Presented here are three cases of severe leptospirosis, one icteric and two pulmonary hemorrhagic, that occurred in patients in Styria, Austria. Leptospirosis presents with protean and nonspecific manifestations. Thus, as these three cases emphasize, the key to diagnosis may be maintaining a high index of suspicion for the disease in previously healthy febrile patients with septic shock, acute renal and hepatic dysfunction and respiratory failure requiring intensive care.

Adolescent↗
PubMed2002

Fatal intracerebral hemorrhage due to leptospirosis.

Intracerebral hemorrhage in leptospirosis is a rare event. We report on a fatal case of intracerebral hemorrhage complicating leptospirosis in a 47-year-old sewage drain worker. Since substantial thrombocytopenia was observed during the course of the disease, postmortem autopsy was performed to further elucidate the genesis of platelet destruction. Due to immunohistological findings, immunologically mediated thrombolysis was considered responsible for thrombocytopenia, whereas no signs of disseminated intravasal coagulopathy or deranged platelet production in the bone marrow were detected.

Antibodies, Bacterial↗
PubMed1976

Leptospirosis in Trinidad and Grenada, with special reference to the mongoose.

In Trinidad, six Leptospira isolates were made from 957 febrile patients between 1968 amd 1972. In addition, CF antibodies were detected in 6-6% of febrile patients and human survey sera collected during this period. In 1972 alone, 10-4% (38/363) of sera examined had CF titres consistent with positive exposure to the disease. Grenada does not report leptospirosis, but the disease is common in mongooses in both Trinidad and Grenada. Serogroups Icterohaemorrhagiae, Pomona and Canicola are present in Grenada with 35-2% of mongooses examined being seropositive. Five Canicola strains of Leptospira were isolated from mongooses in Trinidad and serological studies showed that this was the most common serogroup from mongooses on the island. A total of 31 strains recorded from at least seven different serogroups and eight named serotypes have been isolated from humans, rats and mongooses in Trinidad. Human leptospirosis is probably more common in the Caribbean than the medical records indicate.

Animals↗
PubMed1977

Cardiac and pulmonary involvement in leptospirosis.

The clinico-pathological features of cardiac and pulmonary involvement were studied in seven cases of fatal leptospirosis. Petechial haemorrhages occurred in the heart and pericardium in all cases with blood-stained pericardial effusions in five. Interstitial myocarditis was noted in five patients and probably caused the changing electrocardiographic abnormalities and clinical cardiovascular effects during the illness. Sub-pleural and intrapulmonary haemorrhages occurred in all seven cases with pleural effusions in four. Pulmonary oedema was a striking feature during the early stages of the illness, while in patients surviving the first week of the disease infiltrative and proliferative lesions were common. The latter type of pulmonary changes occurred at a stage when acute renal failure was improving and were not related to the presence and severity of jaundice. The clinico-pathological profile of pulmonary involvement in leptospirosis appears to fall into an adult respiratory distress syndrome and, when present, carries a serious prognosis and would then be a prime factor in mortality. As clinical manifestations of pulmonary involvement appear late during the clinical illness and may be of abrupt onset, auscultatory and radiological surveillance becomes mandatory in severe leptospiral infections.

Adolescent↗
PubMed1982

A survey of leptospirosis in febrile patients mainly from hospitals and clinics in Trinidad.

Acute and convalescent sera were obtained from 202 febrile patients, most of whom were admitted to or attended hospitals or clinics in northern Trinidad during the 12 months from mid-February 1977 to mid-February 1978. Laboratory tests confirmed that 10 of the patients were suffering from current leptospirosis while another 54 had serological evidence of previous leptospiral infections. Antibodies to strains of the Icterohaemorrhagiae serogroup were most commonly found, followed by those to the Hebdomadis and Autumnalis serogroups. Isolates were obtained from the blood of two and the urine of three of the 10 current cases. Four of these strains were identified as belonging to copenhageni serovar of the Icterohaemorrhagiae serogroup and one to serovar brasiliensis of the Bataviae serogroup. Seven of the patients suffering from leptospirosis were males, all rural dwellers, and all except one under 20 years of age. Two of the three female patients were over 60 years old and were urban dwellers. It was not possible to identify the sources of infection with certainty, although dogs may have been responsible for three of the Icterohaemorrhagiae and one of the Canicola infections. Of the 192 patients who were not currently infected, serological evidence of previous infection was obtained in 31 (40%) males and 23 (21%) females and was most common among farmers and rural workers.

Adolescent↗
PubMed1984

The prevalence of severe leptospirosis among humans on Barbados.

Leptospirosis was confirmed by the Leptospira Laboratory in 138 hospital patients on Barbados between early November 1979 and the end of 1982 (annual average 43.6 cases). These were the great majority of severe cases occurring on the island during that time. The crude incidence rate ranged between 15 and 23 per 100,000 population per year (average 17.6). 26 of the patients died (15 males, 11 females), giving an over-all case fatality rate of 18.8%, and an average of 8.2 deaths per year. 68% of all cases were in males. The highest percentages of cases were in males aged 20 to 24 and females aged 55 to 59, but the incidence of the disease in both sexes increased with age up to 60 years. Previous figures recorded on the island by the Ministry of Health for 1975-79 were considerably lower, with a mean of 23.6 cases per year and a crude annual incidence of 9.5 per 100,000. 15 of the patients died (13 males, 2 females), giving an over-all case fatality rate of 12.7% and an average of 3 deaths per year. 74% of all cases were in males. The highest percentages of cases were in the 20 to 29 and 50 to 59 year age groups for males and females, respectively, i.e., similar to those in the present series. In both sexes the incidence of leptospirosis increased with age up to 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Leptospirosis--clinical spectrum and correlation with seven simple laboratory tests for early diagnosis in the Third World.

Twenty-four patients who were clinically suspected of having leptospirosis were subjected to 7 simple commonly available laboratory tests. The 21 patients who had 3 or more positive tests were confirmed serologically to have leptospirosis. The high frequency of acute abdominal pain (71.4%) as a major presenting symptom and the laboratory findings of raised serum amylase levels in a high percentage of patients (84.2%) were especially noteworthy.

Adult↗
PubMedDate not supplied

First evidence of leptospirosis in Vanuatu.

The clinical picture of leptospirosis is often confusing and biological confirmation with reference tests (microagglutination test or isolation of the organism) is not usually possible in tropical countries where the disease remains undiagnosed. We report here the first human cases of leptospirosis in Vanuatu (South Pacific), which occurred during the 1989-1990 epidemic of dengue, and discuss the differential diagnosis of the 2 diseases.

Adult↗
PubMedDate not supplied

Immunodiagnosis of human leptospirosis using saliva.

When the enzyme-linked immunosorbent assay for the detection of specific immunoglobulin M class antibodies was applied to paired saliva and serum samples from 40 patients with leptospirosis, positivity was 87.5% and 100%, respectively. No positive result was obtained with any saliva or serum sample from 60 individuals used as controls. These results suggest the alternative use of saliva for diagnosis and for epidemiological studies of human leptospirosis.

Antibodies, Bacterial↗
PubMed1983

Enzyme-linked immunoassay in the diagnosis of leptospirosis in domestic animals using peroxidase-conjugated protein-A.

The ELISA test for detection of antibodies to Leptospirosis in domestic animals was performed using Staphylococcal protein-A coupled to peroxidase in place of antisera to IgG. Genus- and type-specific antigens were extracted with SDS technique from four pathogenic serotypes and two non-pathogenic ones, and they were identified with the aid of ELISA using specific rabbit antisera. Micro-agglutination (MA) and ELISA were compared using a total of 48 positive swine sera and a 100% agreement was obtained, since with sera from 16 dogs clinically suspected of Leptospirosis the ELISA resulted highly more sensitive and precocious than MA in detecting specific antibodies.

Agglutination Tests↗
PubMed1987

Comparison of the DIFCO and Patoc 1 slide antigens in the screening of leptospirosis.

A comparison of the Patoc 1 slide agglutination (SAT) and DIFCO slide agglutination test for the screening of leptospirosis in man, cattle and coypu (Myocastor coypus Molina) is reported. The economic costs, convenience and availability of the antigens for the tests are analysed. It is recommended that slide agglutination methods alone are not sufficient for the routine diagnosis of leptospirosis.

Agglutination Tests↗
PubMed1992

Serodiagnosis of leptospirosis in pigs using an axial filament enzyme-linked immunosorbent assay.

The axial filament (AF) from Leptospira interrogans serovar canicola was isolated by cesium chloride density gradient centrifugation of 2% sarcosyl treated whole cells. Isolation of AF was confirmed by electron microscopic examination, by protein-A immunogold labelling, sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE), and immunoblotting. Analysis by SDS-PAGE of the purified preparation showed relatively weak bands of molecular size 41 kDa and 21 kDa, and strong bands of 35 kDa and 34.5 kDa. Immunoblot analysis using antiserum to the AF against sonicated leptospires of a variety of serovars showed prominent reaction against the 41, 35, and 34.5 kDa protein bands, as well as against minor bands of molecular weight 43, 39, and 37 kDa. Antisera prepared against leptospiral serovars also identified minor bands at 33 and 32 kDa. Immunoblots with antiserum to whole cells of serovar bratislava detected the 35 and 34.5 kDa AF bands of Borrelia burgdorferi moderately and of Treponema hyodysenteriae only slightly in comparison to leptospiral AF. Antibody to B. burgdorferi did not detect the leptospiral AF antigen. Immunoblots with antiserum to T. hyodysenteriae showed a marked reaction with a 41 kDa band of B. burgdorferi but only a very minor reaction with leptospiral AF. The AF was tested in an AF-ELISA against sera from 260 pigs, many of which reacted in the microscopic agglutination test (MAT) against one or more leptospiral serovars. A sensitivity of 97.1% and a specificity of 93.1% was determined in comparison to the MAT. Only moderate correlation was observed between titres detected in the AF-ELISA and the MAT (r = 0.4). When sonicated whole cells (WC) of serovar canicola were used in an ELISA (WC-ELISA), high correlation was observed between AF-ELISA and WC-ELISA (r = 0.97). These findings show that the AF-ELISA can be used effectively as a species-specific antigen for the serological diagnosis of leptospirosis in swine and that sonicated whole cells can substitute excellently for purified AF as the antigen source. These findings may be extrapolated to the use of AF in immunodiagnosis of leptospirosis in other species.

Agglutination Tests↗
PubMed2005

[A rare aetiology of acute respiratory distress syndrome in adult: leptospirosis].

We report the case of an 18-year-old man with pulmonary leptospirosis presenting as an atypical pneumonia with alveolar haemorrhage, without icterus. Has he developed ARDS the patient was admitted in intensive care unit. This patient was contaminated when swimming in a lake. The purpose of this article is to remind doctors that in patient presenting atypical pneumopathy with haemoptysis, the pulmonary leptospirosis should be considered.

Adolescent↗
PubMed2005

Whole-genome analysis of Leptospira interrogans to identify potential vaccine candidates against leptospirosis.

Leptospirosis is an important global human and veterinary health problem. Humans can be infected by exposure to chronically infected animals and their environment. An important focus of the current leptospiral research is the identification of outer membrane proteins (OMPs). Due to their location, leptospiral OMPs are likely to be relevant in host-pathogen interactions, hence their potential ability to stimulate heterologous immunity. The existing whole-genome sequence of Leptospira interrogans serovar Copenhageni offers a unique opportunity to search for cell surface proteins. Predicted genes encoding potential surface proteins were amplified from genomic DNA by PCR methodology and cloned into an Escherichia coli expression system. The partially purified recombinant proteins were probed by Western blotting with sera from human patients diagnosed with leptospirosis. Sixteen proteins, out of a hundred tested, were recognized by antibodies present in human sera. Four of these proteins were conserved among eight serovars of L. interrogans and absent in the non-pathogenic Leptospira biflexa. These proteins might be useful for the diagnosis of the disease as well as potential vaccine candidates.

Antigens, Bacterial↗