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In a retrospective study of 60 cases of leptospirosis, the association of thrombocytopenia and acute renal failure as previously reported was confirmed. However, increased mortality, in our experience, was not associated with either thrombocytopenia or acute renal failure.
The clinical, laboratory, and serological findings in 17 dogs with disease resulting from leptospiral infection were evaluated retrospectively. Acute renal failure was the most common syndrome, but cholestatic hepatic disease also was common. The most prevalent serovars identified were pomona, grippotyphosa, and autumnalis. Paired serology was available on 10 dogs. Aggressive fluid therapy in combination with ampicillin or amoxicillin resulted in a good survival rate. Canine leptospirosis may be more common than suspected, and paired serology often is necessary to confirm a diagnosis.
The diagnosis of leptospirosis is often difficult to make because of vague and mild symptoms. Patients who present with a "flu-like" illness and who have had either direct or indirect contact with infected animals should be investigated by serological examination. In Western Australia during 1983 and 1984, the sera of 937 patients were tested for the presence of leptospiral antibodies. Of these, 131 gave positive results; in 45, these were consistent with recently acquired infection. Apart from one veterinary worker, all the cases that were diagnosed serologically occurred in farmers and meatworkers. Farmers were most often infected with serovar hardjo. Meatworkers demonstrated a high degree of cross-reactivity among serovars pomona, hardjo, and to a lesser extent, icterohaemorrhagiae. However, in cases in which the infecting serovar was identifiable serologically, serovar pomona predominated.
A study was conducted to evaluate leptospirosis in brown rats (Rattus norvegicus), muskrats (Ondatra zibethicus) and mice (Mus musculus) in southeastern Larimer County, Colorado. Leptospira serotype icterohaemorrhagiae was isolated from fourteen of 143 feral brown rats, an infection rate of 9.8%. Serological evidence of infection with this stereotype was found in 66.4% of the rats. Serological evidence of L. serotype ballum infection was present in three of 17 muskrats. Leptospires were seen in histological sections of kidney tissue from two of 61 feral mice. No isolations were made from cultures and serology was not done on mice.
Serum samples from 153 woodchucks (Marmota monax) from Tompkins County, New York, obtained in 1976 and 1977, were examined by plate agglutination tests for antibodies against five Leptospira antigens. Fourteen sera showed significant titers against either L. hardjo, L. icterohemorrhagiae and/or L. pomona. Reactions against L. hardjo were the most frequent. Woodchucks collected from two dairy farms with histories of bovine leptospirosis did not have a greater prevalence of antibodies than woodchucks collected from other locations. Each of two woodchucks experimentally-inoculated with L. hardjo developed titers to L. hardjo. Maximum titers occurred approximately 30 days post-inoculation. L. hardjo was not observed in urine specimens of these animals.
During a skunk eradication program in late August, 1979, 53 striped skunks (Mephitis mephitis) were removed from three public use areas on Beaver Lake, Benton and Carroll counties in northwestern Arkansas. None of the 53 animals were positive for rabies (fluorescent antibody technique) and only one of 45 (2.2%) was positive for rabies antibodies. Twenty-one of 45 animals (46.6%) tested were positive for leptospirosis; 10 of 45 (22.2%) were positive for toxoplasmosis; and none were positive for tularemia. High populations of striped skunks in public use areas could be a potentially important reservoir for several diseases affecting both humans and other animals.
A serologic survey was conducted on 628 white-tailed deer (Odocoileus virginianus) in 1976 and 1979-1980. Tests for antibodies to the etiologic agents of infectious bovine rhinotrancheitis (IBR), parainfluenza 3 (PI3), leptospirosis, and brucellosis produced positive results of 15%, 20%, 3% and 0%, respectively. Adult deer had significantly higher prevalence of antibodies to IBR virus and PI3 virus than fawns. These data provide a basis for monitoring these disease agents in Minnesota's white-tailed deer.
The role of the red fox (Vulpes vulpes) in the epizootiology of leptospirosis in southwestern Ontario was investigated in 1973-1974. Leptospira interrogans serovar pomona (kennewicki by DNA analysis) was isolated from the kidneys of three of eight foxes tested. Severe hemorrhagic nephritis and interstitial nephritis were common to these foxes and to five others out of nine foxes examined. Autumnalis antibodies were detected at titers 10(-2) to 10(-5) in 12 of 100 fox sera. Pomona antibodies occurred in 6% of the sera, always accompanied by autumnalis antibodies, and at titers never exceeding the autumnalis titers. Cultural, serological, and pathological findings together indicated that the red fox could have been acting as an amplifier host, but not as a maintenance host, for pomona.
A study was undertaken on wild animals to determine the seroprevalence of animal leptospirosis in Korea. Using the serum microagglutination test for 19 serogroups, it was shown that two of 26 rats (Rattus rattus) had antibodies to Leptospira canicola. When data for domestic animals were included, the most prevalent (nearly 50%) serogroup was Leptospira canicola.
The sensitivity and specificity of the microscopic agglutination test (MAT) as a method for detection of exposure to Leptospira spp. in California sea lions (Zalophus californianus) were determined. Sera came from individuals that demonstrated clinical signs of renal disease, had lesions suggestive of leptospirosis at necropsy, and had visible leptospires in silver stained kidney sections as positive controls. Sera from unexposed captive individuals were used as negative controls. The test was 100% sensitive at 1:3,200 for confirming renal infection and 100% specific at negative < 1:100 for detection of Leptospira interrogans scrovar pomona antibodies by MAT in California sea lions. Leptospira interrogans serovar pomona was used as a screening serovar because it has been isolated previously from the kidneys and placentas of California sea lions, and there appears to be cross-reactivity between serovar pomona and other serovars. Sera from 225 free-ranging California sea lions presented to one of three participating California (USA) coastal marine mammal rehabilitation centers in 1996 were then evaluated for antibodies to serovar pomona using the MAT. The overall seroprevalence was 38.2% (86/225), although the prevalence varied among locations from 100% (38/38) in animals at the Marine Mammal Care Center (Fort MacArthur, California, USA) to 0% (0/14) at SeaWorld California (San Diego, California). At The Marine Mammal Center (Sausalito, California) [prevalence 27.8% (48/173)], the majority of seropositive animals were subadults and adults, and males were 4.7 times more likely to be seropositive to serovar pomona than females. When combining results from all three centers, subadult and adult animals were more likely to be seropositive than pups and juvenile sea lions, and the highest proportion of seropositive animals presented during the autumn months. Serum elevations of blood urea nitrogen, creatinine, phosphorus, and/or calcium were associated with seropositivity to serovar pomona. We found no association between potassium or sodium levels and seropositivity.
The flood disaster involves the danger of development of dangerous epidemic and episodic events on leptospirotic endemic area in the nearest spring and summer. The authors present a case of severe hemolytic leptospirosis as a results of gastrointestinal tract infection of 3 strains of leptospira. Polymorphism leptospirotic symptoms were discussed. The authors suggest the concept of the influence of plasma betaphospho-lipoprotein deficiency on cytoplasmatic respiration and substrate phosphorylation of morphologic elements of the blood, vessel endothelium and stroma cells.
Facial palsy, one of the most common neurological syndromes, has many causes. This is the first report of a patient with leptospirosis who developed facial palsy. The lesion responded to treatment with doxycycline hyclate.
We report on six cases of leptospirosis observed in fifteen years in our department of nephrology. The contamination is two times from professional origin and four times linked to water leisures, during hot season, from june to september for the majority. Two serotypes are found: L. icterohaemorragiae characterized by marked jaundice, and L. patoc with anicteric form. Acute renal failure, five times oliguro-anuric, necessitates in the six cases hemodialysis (two to six sessions). Meningitis is found in four patients, associated in one case to an encephalitis and a polyradiculoneuritis. In one case, there were interstitial pulmonary lesions, in one another, a myocarditis with conduction disorders, responsible of the only death of this series, and finally, in three cases, a gastrointestinal hemorrhage. Bacteriological diagnosis seems little profitable and microagglutination remains the reference technique, helped by the IgM detecting through ELISA, looking forward to the evaluation of PCR (Polymerase Chain Reaction).
A study of 1,437 unselected febrile patients in rural Malaysia yielded a diagnosis of leptospirosis in 86 (6.0%). The clinical syndrome was mild to moderate in all cases, jaundice was observed in only 2 (2.3%) and no deaths were documented. The diagnosis was not clinically obvious in most cases, and it is apparent that many infections must be going unnoticed at present.
A controlled double-blind trial was conducted with the participation of 80 adult volunteers of both sexes, who were randomly divided into groups of 40 individuals each one. The case-base study received the vaccine and the control group was administered placebo to know the safety, the behaviour of reactogenicity, and to star the immunogenicity studies of the first Cuban vaccine against human leptospirosis. The vaccine used in the case-base study was an inactivated and trivalent vaccine containing strains of Leptospira canicola, icterohaemorrhagiae and pomona, since they have the highest circulation in the country. The results obtained showed the inocuity of the vaccine as no adverse severe reactions were detected. The general symptomatology observed was low, where as febricula was the most common general symptom. It appeared during the first 3 days of observation and there were no significant differences between the 2 group. Only a mild pain at the site of the injection was reported as a local symptom, which was more frequent in the vaccinated group than in the control group (7.8 against 1.5%, respectively). The seroconversion obtained was of 29% by microagglutination, and of 34.2% by ELISA. The final results allowed to conclude that this vaccine is safe for human adults at the ages under study, and give the possibility to continue other studies in more advanced stages to complete the requirements for obtaining its license.
We report a case of a 48-year-old man from western Austria with severe leptospirosis. This disease occurs worldwide but predominates in the tropics. The infectious urine of a wide variety of domestic and wild animals mediates transmission of the infection, which characteristically has a biphasic pattern. It begins with the "leptospiraemic phase" with high fever, conjunctival suffusion, muscle pain and headache. Hepatitis, nephritis and haemorrhages may follow. The second "immune phase" has a greater variety of clinical manifestations. Fever and the initial symptoms may recur and the central and peripheral nervous system may be involved. The patient reported showed all major characteristics except conjunctival suffusion. The outcome was favourable despite some conditions with a poor prognosis (jaundice, renal failure, haemorrhages). The extreme severity of jaundice and the xanthopsia (yellow vision) make the case unique.
Five cases of leptospirosis diagnosed from 1978 to 1996 were retrospectively reviewed. The five patients were male and their mean age was 34.2 years. Epidemiologic factors were found in the 5 patients. The 3 common clinical findings: fever, myalgia and jaundice were found in the 5 patients. Hepatorenal involvement was observed in 4 cases (80%), bleeding episodes in 4 patients (80%), cardiac involvement in 4 (80%); in none case was observed central nervous system involvement. In one case (20%) was observed septic shock with acute respiratory failure. The Leptospira serogroups identified were icterohaemorrhagiae in 3 cases and could not be determined in 2. All the patients were amelioration with antibiotic therapeutic. The epidemiologic, clinical, analytical and therapeutic aspects are discussed.
The leptospirosis and the hantaviral infections are worldwide distributed zoonoses having the similar epidemiology and clinical symptoms. Both in Europe and Asia those hantaviral serotypes are common which are responsible for the haemorrhagic fever with renal syndrome, while on the American continent the hantaviral pulmonary syndrome has also been diagnosed. Authors describe a patient who had simultaneous leptospira and hantaviral infections with haemorrhagic fever as well as with mild, transient renal insufficiency and liver damage. The dual infection was proved by serology.