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PubMed1987

[Pulmonary manifestations in severe ictero-hemorrhagic leptospirosis].

Eight cases of pulmonary involvement were observed in 17 severe cases of ictero-haemorrhagic leptospirosis. Haemoptysis (7 cases) occurred on the 4th day of the infectious syndrome and was associated with other haemorrhagic manifestations in 4 cases. Cough, pain and polypnoea were not constant. Chest X-ray showed diffuse, non-specific changes, such as nodular opacities or infiltrates. Septicaemia was confirmed in all cases with acute renal failure in 7 cases and meningitis in 6 cases. Severe thrombocytopenia was demonstrated in 2 cases. Six patients recovered quickly with regression of the lung changes within 12 days. Two patients died, one of a fulminant haemoptysis related to a disseminated intravascular coagulation syndrome, and the other of acute respiratory failure. All cases were confirmed serologically. Although lung changes in leptospirosis are usually benign and mild, haemoptysis and polypnoea with diffuse radiological changes are poor prognostic factors. The pathological changes were similar to those of haemorrhagic alveolitis. These changes may be either due to the liberation of toxins or to an immunological phenomenon.

Adolescent↗
PubMed1985

[Predominant pulmonary manifestations in leptospirosis icterohemorrhagica].

14 cases of leptospirosis ictero-haemorrhagica observed on Reunion island with predominant or isolated pulmonary symptoms are described. Hospitalisation was motivated in every case by haemoptysis, at times profuse, which occurred in patients with fever and myalgia. The chest radiographs revealed an alveolar and/or a bilateral alveolar pattern of variable severity. In spite of the importance of chest radiography port raying an extensive and serious pneumonia in one case out of every two, the outcome was favourable with a mean time lag of one week. In three cases, an adult respiratory distress syndrome (ARDS) was seen requiring assisted ventilation and one death occurred. The diagnosis of leptospirosis may be considered, even in countries of low endemicity, in a case pneumonia with extensive haemoptysis or an adult respiratory distress syndrome whose cause is not established by the usual tests.

Adolescent↗
PubMed1979

[Icterohemorrhagic leptospirosis with acute renal failure (author's transl)].

Icterohemorrhagic leptospirosis is a zoonosis which is relatively frequent in rural agricultural or cattle areas. In the severe forms of the disease renal affection is frequent, but the incidence of acute renal insufficiency is far lesser. Three cases of acute renal insufficiency in adult male patients secondary to an infection by Leptospira icterohaemorrhagiae are presented. Two of the patients resided in urban areas and only one of which presented professional risk. The clinical polymorphysm of the illness is confirmed, having observed not only the absence of fever but also that of jaundice. The former history of chronic alcoholism, present in two cases, determined diagnostic difficulties with acute alcoholic hepatitis. The serologic diagnosis is often positive only at the end of the second week, and the need to carry out a series of seroaglutinations is to be insisted upon. The types of renal impairment in leptospirosis are reviewed and the presence of acute renal insufficiency is stressed, including those patients with less severe forms of the disease, and especially those without Weil's syndrome. All of the patients had to be treated with dialysis, although two of them had a conserved diuresis after an initial brief period of oliguria.

Acute Kidney Injury↗
PubMed1983

[Etiological structure of icterohemorrhagic leptospirosis in gray rats (Rattus norvegicus)].

In 93 Leptospira strains isolated from Norwegian rats serovar determination was made. As a result, leptospires circulating among Norwegian rats were found to belong mainly to serovar copenhageni, group Icterohaemorrhagiae, while leptospires of serovar icterohaemorrhagiae, even if occurring, were found only in the animals inhabiting pigsties. Leptospirosis epizooty among rats, caused by L. icterohaemorrhagiae, took its course independently of leptospirosis epizooty among mice, caused by L. hebdomadis, and simultaneously with it.

Animals↗
PubMed1983

[Pathomorphology of toxico-infectious shock in influenza and leptospirosis].

Examinations of the section material of fatal cases due to leptospirosis and influenza, as well as examinations of organs in experimental toxic influenza by light and electron microscopy with determinations of the infectious and immune complexes showed leptospira and influenza virus to be capable of causing toxico-infectious shock (TIS) with typical changes in the microcirculatory bed and organ parenchyma. TIS should be considered to be a special form of the course of an infectious process in which different organs may be "shock organs" depending on the tropic properties of the causative agent: in leptospirosis - the kidneys and liver, in influenza - the lungs and brain.

Animals↗
PubMed1982

[Nature of the antibodies in persons inoculated with a leptospirosis vaccine].

The results obtained in the study of the intensity and character of immunity in persons immunized with commercial leptospirosis vaccine are presented. These results indicate that antibody formation occurs only in 12.5% of the vaccinees; antibodies are not formed to all Leptospira strains contained in the vaccine, and in 6 months all antibodies completely disappear. In persons immunized with a single vaccine dose the agglutinating activity of blood sera was linked only with IgM. In persons subjected to multiple immunizations for a number of years IgG could also be detected. Cases of leptospirosis among vaccinees have been registered.

Adult↗
PubMed1993

[Human leptospirosis behavior in Cuba].

A description is made of the antecedents of human leptospirosis in Cuba and the behavior of the disease from 1981. An analysis with regards lethality and incidence during the five-year period 1986-1990 was carried out; the most affected provinces, the months of highest occurrence, and the most hazardous occupations, are listed. The present situation of human leptospirosis in Cuba is described and recommendations are provided.

Adolescent↗
PubMed1994

[Diffuse alveolar hemorrhage and myositis in icterohemorrhagic leptospirosis. Rapid control by a single bolus of corticoids].

Leptospirosis is one of the commonest causes of diffuse alveolar haemorrhage. Despite good sensitivity to penicillin and current techniques of ventilation, there remains a considerable mortality which is particularly linked to the initial pulmonary disease at presentation. The authors describe a new case of a gravely ill patient with leptospirosis and sever hypoxaemia. There was diffuse alveolar haemorrhage and myositis thus a bolus of corticosteroids was used over the first 24 hours complementary to the traditional treatment.

Adrenal Cortex Hormones↗
PubMed1994

[Analysis on early serum samples from patients with leptospirosis by polymerase chain reaction].

Fifty-five serum samples from patients with leptospirosis treated by the method of high SiO2 concentration salt solution absorption were analysed with the variable sequences of the 16S rRNA genes of Leptospria interrogans as primers. It is shown that the 16S rRNA gene primer is useful for the clinical detection and the epidemic investigation of leptospirosis, and the detecting effect by PCR is superior to that by the blood culture and MAT (P < 0.01).

Genes, Bacterial↗
PubMed1994

[Characteristics of lymphocyte-monocyte-neutrophil interactions during varied-severity course of leptospirosis (a cytochemical study)].

Correlations between neutrophilic enzymes (acid and alkaline phosphatases, myeloperoxidase, NBT test) and lymphocyte and monocyte enzymes (acid phosphatase, nonspecific esterase) were studied in 110 patients with icterohemorrhagic leptospirosis. These correlations were changing, depending on the disease severity and period. In case of a favorable course of leptospirosis in the initial period and at the peak a great number of intercellular correlations are formed between neutrophilic, lymphocytic, and monocytic enzymes. If the disease course is grave and complicated the intercellular relationships are ruptured at the peak of the illness. Convalescence is characterized by a gradual recovery of intracellular correlations.

Adolescent↗
PubMed1996

[Isolated febrile intra-alveolar hemorrhage detected in leptospirosis].

We report observation of a patient of 25 years who presented with an isolated intra-alveolar haemorrhage occurring during the course of an illness suggestive of septicaemia. Considering the epidemiological context of inhalation of water from the River Saone, the diagnosis of acute leptospirosis ictero-haemorrhagica was considered and was confirmed by serological tests. Several publications draw attention to the pulmonary manifestations of acute leptospirosis which remains rare and poorly understood. Pulmonary disease is characterised not by an infectious alveolitis but by the occurrence of intra-alveolar haemorrhage whose pathogenetic mechanism remains under discussion.

Adult↗
PubMedDate not supplied

[Study of acid lability of DNA in patients with leptospirosis].

Measurements of DNA and study of chromatin status in blood cell nuclei help solve numerous basic problems of biology and medicine. Acid lability of DNA was assessed in 5 patients with grave icterohemorrhagic leptospirosis. The distribution of fluorescence peaks on the curve of neutrophil DNA hydrolysis in patients with grave leptospirosis indicates that functionally low-active acid-resistant DNA fraction predominates in their chromatin. Assessment of acid lability of DNA is proposed to be used for assessing the severity of the pathological process.

Acids↗
PubMed1997

[Relationship between cytochemical activity of leukocytes and autorosette formation phenomenon and its clinical significance in patients with leptospirosis].

The content of autorosettes in the peripheral blood forming from red cells round neutrophils and monocytes was found increased during the acute period of icterohemorrhagic leptospirosis. Autorosette-forming cells are characterized by a high activity of alkaline and acid phosphatases and low NBT-test values. The content of autorosettes directly correlates with the disease severity, bilirubin level, and presence of anemia. Assessment of autorosette-forming cells in patients with leptospirosis may be used as an additional test for evaluating the severity of intoxication, disease course, and for predicting the complications and disease outcome.

Acid Phosphatase↗
PubMed1979

Serological evidence of human leptospirosis in northern Greece.

a) 1069 human blood samples were tested for the presence of C. F. antibodies to leptospirae. 98 of these sera were from patients suffering from Weil's syndrome. 13 out of 98 patients were found to be suffering from leptospirosis; one of these died. 460 sera were from patients with febrile (acute) illness of unknown origin and 511 sera from patients with respiratory disease (especially "influenza like disease"). None of these patients was found to be suffering from leptospirosis. b) 191 human sera from healthy people at risk to leptospiral infection were examined by microscopic agglutination test (MAT). A high percentage (14.1%) was found to have antibodies against one or two leptospiral serogroups. The results obtained suggest that the incidence of leptospiral infections in humans in Northern Greece is higher than previously reported and the predominant serogroups were found to be Icterohaemorrhagiae followed by Autumnalis and Canicola.

Agglutination Tests↗
PubMedDate not supplied

[Hemostatic disorders in a severe course of icterohemorrhagic leptospirosis (a clinico-morphological study)].

Morphologic studies were made on the brain tissue and internal organs of those deceased (n = 75) who had died of leptospirosis icterohemorrhagica during different periods of the condition, with the results obtained being compared to clinical and laboratory findings. It has been shown that realization of the pathogenic potential of the disease-producing germ is exercised both through direct generalized injury to the endothelium of microvessels, parenchymal cells (predominantly those of the liver and kidneys) by toxic substances of Leptospira and (to a larger degree) through disorders of hemostasis presented as thrombosis of vessels of the microcirculatory bed with subsequent development of hemorrhagic manifestations and alterative changes of hypoxic genesis in vital organs. Early haemocoagulatory disorders are characterized by marked and stable hypocoagulation, with direction of the processes of fibrin formation and fibrinolysis being different, which fact is consistent with diversity of structural formations originating from fibrin in the microcirculatory bed of the deceased. Prophylaxis of grave pathologic changes in the organism leading to lethal outcome consists in correction of hemostatic disorders during early phases of the disease course, which is to be pathogenetically substantiated and situational one because of the problem posed by verification of stages of that syndrome of disseminated intravascular coagulation in patients with grave course of leptospirosis icterohemorrhagica.

Acute Disease↗
PubMedDate not supplied

[The role of rheohepatography in assessing liver function in leptospirosis].

A rheographic investigation on the liver in patients with leptospirosis revealed substantial disturbances in the system of hepatic circulation, which observation was regarded as corresponding to gross morphologic changes in the liver. Potentialities are shown of hepatorheography in assessment of severity of injury to the liver and degree of its return to normal in leptospirosis.

Acute Disease↗
PubMed1989

Leptospirosis. Epidemiological features of a sporadic case.

Leptospirosis occurred in a 45-year-old man with presumed infection from an exposure to contaminated water at his source of employment. An intensive epidemiological investigation, including serological examination of all family members and pets and cultures on the patient and his family pets (cats and dogs), proved that the leptospiral organism was acquired by the patient's exposure to his dogs. The risk of acquiring infection from dogs that are asymptomatic and vaccinated is emphasized by this report.

Animals↗
PubMed1987

Acute renal failure in leptospirosis--a 12-year survey.

From the beginning of 1974 to the end of 1985 141 persons in Slovenia (population 1.9 million) contracted leptospirosis 49 patients were 50 years old or more. All the patients have survived. 8 male patients aged from 18 to 44 had more severe acute renal failure (ARF), 5 of whom were treated with hemodialysis. The authors found that this 100% survival rate did not agree with the findings of many other researches which quote a relatively high mortality rate among older patients. In all 8 patients kidney function was good 1 year or more after ARF. The authors consider that the survival of patients with ARF depends on early and appropriate supportive treatment, which also includes intensive hemodialysis.

Acute Kidney Injury↗