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[Clinico-radiological observations on pulmonary manifestations of leptospirosis during the Montefeltro epidemic].

During the summer of 1984, in the Montefeltro area an epidemic of leptospirosis took place from a common source. In 15% of the people affected, the disease involved the lungs. In 3 patients the disease had a deadly course; one decrease was due to ARDS. The clinical, anatomopathological, and radiological features are described of the patients who presented with lung involvement. Such an outcome proved to be more likely than we thought. X-ray pattern of the chest was a polymorphous appearance, in spite of the same anatomopathological substratum, characterized by lung edema and endoalveolar hemorrhages.

Adult↗
PubMed1987

Leptospirosis risk in public cleansing and sewer workers.

The degree of leptospirosis risk was investigated in 80 sewer and 120 public cleansing workers. They were interviewed and their serum samples tested for the presence of leptospiral antibodies by the sensitised erythrocyte lysis (SEL) test. Another 100 control subjects matched by sex, age and ethnic group were similarly studied. The study subjects had higher seroprevalence than the controls--over six times higher for SEL titres of greater than 1:100 and over 1.5 times for titres of greater than 1:25. The highest seroprevalence was found in workers cleaning wet markets and food centres. There was no significant correlation between the prevalence of positive titres and symptom prevalence or hospitalisation. Five of the study subjects (all sewer workers) gave a history of jaundice.

Antibodies, Bacterial↗
PubMed1987

Leptospirosis from the clinical viewpoint.

Epidemiological, clinical and microbiological data of 27 patients suffering from leptospirosis are presented. Because of the sporadic occurrence of the disease, diagnosis on admission was correct in only 18% of the patients. As proved by the agglutination test, most of the infections were due to serotype icterohaemorrhagiae, but in only one case could the leptospires be detected directly in the blood culture. In most of the cases the course of the disease was moderately severe with one fatality. Symptomatology and treatment are discussed.

Adolescent↗
PubMed1986

[The use of direct immunoenzyme analysis with genus-specific peroxidase conjugate in leptospirosis].

For the first time anti-Patoc I peroxidase conjugate was obtained from the serum of a hyperimmunized guinea pig by the method of Nakane and Kawaoi (1974) in the modification of Mathiesen et al. (1978). In the experimental study of 37 Leptospira strains belonging to 19 serological groups, carried out with the use of direct EIA techniques, anti-Patoc I peroxidase conjugate was found to be genus-specific and highly active. The possibility of detecting Leptospira antigens of 7 serological groups in the blood and in suspensions of the liver and kidneys of golden hamsters by direct EIA with the use of the above-mentioned conjugate was established. The use of direct EIA with anti-Patoc I peroxidase conjugate for the diagnosis of leptospirosis is recommended.

Animals↗
PubMed1987

To the knowledge of the common hamster (Cricetus cricetus Linné, 1758; Rodentia) as host of leptospirosis in Czechoslovakia.

A total of 1288 hamsters (Cricetus cricetus), coming from two regions of Czechoslovakia, were serologically investigated on the presence of leptospirosis. In 1114 hamsters from eastern Slovakia, where an outbreak occurred and local populations lived quite atypically, there was 31.8% positivity, in 174 animals from central Moravia, where the populations were at higher levels but lived normally, the positivity amounted to 17.2%. The serological positivity increases proportionately to the weight, i.e. to the age of the animals. The serovar grippotyphosa was dominant in them (29.6% of examined hamsters), while 6.0% were positive for L. pomona, 1.0% for serovars from the serogroup Sejroe, 0.2% for L. sorex-jalna and L. bataviae respectively, and 0.1% for L. bratislava. The hamsters from central Moravia were positive only for the serovar grippotyphosa. Antibodies in lower titres against L. pomona, having the character of coagglutinations, were simultaneously detected in some hamsters positive for L. grippotyphosa. In Czechoslovakia the common hamster is one of the potential hosts of L. grippotyphosa, its importance increasing during severe outbreaks, when the incidence of infection with L. grippotyphosa in hamster populations increases and the animals inhabit most varied types of biotopes and transfer to synanthropic way of life.

Animals↗
PubMed1987

[Human leptospirosis in New Caledonia and dependencies. Apropos of 57 cases observed between 1 June 1983 and 31 May 1985].

57 cases of leptospirosis were diagnosed in New Caledonia (South Pacific French Territory) between June 1983 and May 1985. 25% cases are severe infections; thrombopenia and renal failure are frequently observed. Leptospires are found in blood or spinal or urine culture confirmed by haemagglutination tests on microplates (Martin et Petit). Epidemiological studies are being performed during 1985-1986 to devise preventive measures adapted to the territory.

Adult↗
PubMed1987

The incidence of severe leptospirosis in Trinidad.

Between February 1977 and September 1982, sera from febrile patients from all areas of Trinidad were examined for leptospiral agglutinins; 158 of 1714 patients (9%) were confirmed as current cases of leptospirosis (annual average 26 or 2.6 per 100,000 population). Of the remaining 1556 patients only 711 provided paired sera; 167 of these (23%) showed evidence of previous leptospiral infection. Of the 845 single samples, 125 were positive. The true incidence of the disease is probably much higher than reported here. Males comprised 74% of the current cases; their highest rate of infection was in the 30-39 year age group, the incidence in late teenage approaching this rate. For females, incidence increased with age up to late middle-age. The presumptive infecting serogroups most commonly recorded among the 158 current cases were Icterohaemorrhagiae (37%), Canicola (16%) and Autumnalis (11%). 13 of the cases died (case fatality rate, 8.2%).

Adolescent↗
PubMed1987

The effect of human leptospirosis on the composition and concentration of serum lipids and lipoproteins.

1. Plasma lipids and lipoproteins were studied in 9 male patients during the immune phase of leptospirosis and 4 months later after recovery. 2. Electrophoretic patterns of plasma lipoproteins were characterized by the absence of alpha- and pre-beta lipoprotein bands and the presence of a single broad beta band. The high-density lipoprotein (HDL) fraction ran in the pre-beta position and triglyceride (TG) content was high. Low-density lipoproteins (LDL) moved into three different bands and were rich in TG. Very low-density lipoproteins (VLDLs) migrated normally and their triglyceride content was low. All lipoprotein fractions had low levels of cholesteryl esters. 3. In infected patients, the fractional lecithin:cholesterol acyltransferase (LCAT) rate (%/h) was low, while the molar LCAT rate (mumol 1(-1)h-1 remained unchanged. Both VLDL and LDL cholesterol levels increased while HDL cholesterol decreased. 4. These findings demonstrated that abnormalities in lipoprotein composition are associated with leptospiral liver injury.

Adult↗
PubMed1986

[Morphology of a natural focus of Pomona leptospirosis in a steppe area].

The natural focus of Leptospira pomona infection has been found to include areas of the forest-meadow flood plain where the circulation of leptospires is constantly maintained among small mammals (the nucleus of the focus). A high level of Leptospira carriership (17.7%) among the animals has been registered in the central part of the flood plain and near the terraces, these areas having the most favorable conditions for the development of epizootic leptospirosis.

Animals↗
PubMed1985

[Seroepidemiologic study on leptospirosis in the Camargue region].

The damp environment and density of animal population in Camargue are good arguments for the study of leptospirosis. A serological and epidemiological survey on 642 blood samples revealed 36 (5.6%) with significant antibody titers. Icterohaemorrhagiae is followed by Canicola, Grippotyphosa, Australis and Ballum... The most endemic area is not Camargue but the area situated at the northeast (Basse-Durance). Women are twice more affected than men. These two results are not consistent with our initial hypothesis. It is always advisable to seek the etiology of fevers of unknown origin.

Adolescent↗
PubMed1985

Laboratory and clinical features of experimental feline leptospirosis.

In order to assess the clinical, laboratorial and epidemiological aspects of feline leptospirosis, ten female and male adult cats were experimentally inoculated with pathogenic and autochthonous field isolate of Leptospira interrogans. Five of them were inoculated subcutaneously with serovar icterohaemorrhagiae (R-192) and the others five with serovar canicola. No clinical and laboratorial alterations were found in these animals. Antileptospiral agglutinins were detected in 90% of the infected cats, shortly after the 1st week after inoculation. The leptospiral agglutinins were detected for 8 to 12 weeks and the elimination of leptospires through urine was observed only in animals infected with serovar canicola, beginning 2 to 4 weeks after inoculation and lasting for 2 to 8 weeks. Isolations of leptospires from blood and kidneys were unsuccessful.

Animals↗
PubMed1979

Leptospirosis acquired in Surinam.

A case of leptospirosis seen in the Netherlands but acquired in Surinam is described. Marked jaundice, disturbance of renal function, a first degree atrioventricular block and pancreatic irritation were observed.

Adult↗
PubMed1979

Antibodies against Leptospira biflexa serotypes patoc and são paulo in pigs: possible occurrence and importance for the intracutaneous test for leptospirosis.

Leptospirin for the diagnosis of leptospirosis by an intracutaneous test contains antigenic material from 5 pathogenic Leptospira serotypes (10). During experiments with rabbits and pigs, leptospirin was injected into 6 pigs which had been infected artificially with apathogenic Leptospira biflexa serotypes patoc and são paulo. Three out of the 6 pigs showed a positive leptospirin reaction (11). This interfering reaction in animals having been infected with apathogenic L. biflexa was the reason to investigate the occurrence of biflexa antibodies in pigs from different areas in Germany by the microscopic agglutination. None of the 854 pigs showed biflexa antibodies producing a 50% agglutination at a serum dilution of 1:100. If at all, pigs may become infected naturally by L. biflexa; this apparently seems to be a rare incident. An impairment of the diagnostic value of leptospirin by L. biflexa antibodies can be excluded.

Animals↗
PubMed1979

Evaluation of the use of "thermoresistant" antigen Patoc 1, in the diagnosis of human and animal leptospirosis. Preliminary report.

The macroagglutination test, according Mailloux, was investigated for its feasibility in the rapid diagnosis of human and animal leptospirosis. Suspected sera examinated by Mailloux test, were also examinated by Complement Fixation and Microagglutination; the results suggest that: Mailloux macroagglutination is the serological test of choice, for screening of animal and human sera, mostly if it is not needed to know the infecting serovar.

Agglutination Tests↗
PubMed1978

[Formation of group and intergroup antibodies in humans with leptospirosis infections].

The authors studied regularities attending the biosynthesis of group (homologous) and intergroup (heterologous) antibodies in man during the whole cycle of leptospirosis infection, and for three months after it. Leptospira of the serological groups Pomona, Grippotyphosa, Icterohaemorrhagiae, Hebdomadis, the most prominent in the morbidity structure at present, served as etiological causative agents of the disease. Biosynthesis of both homologous and heterologous antibodies had its specific features for each serological group of the disease, and was characterized by the quadripol dynamics of 19S-macro and 7S-microglobulin antibodies production in leptospiroses of serological groups Pomona and Gryppotyphosa, whereas in leptospiroses of serological groups Icterohaemorrhagiae and Hebdomadis a graphically dipolic synthesis dynamics of 19S-macroglobulin antibodies alone was noted.

Antibody Formation↗
PubMed1977

Leptospirosis in New England.

Although rarely reported in humans in New England, leptospirosis is enzootic in western and central Massachusetts. Recently there were three cases of Leptospira interrogans, serotype var pomona, in Easthampton, Mass. Our study and others indicate a potential for waterborne epidemics in humans.

Adult↗
PubMed1984

[Leptospirosis with isolated cardiac manifestations].

A case of leptospirosis with isolated myocardial involvement is reported. Diagnostic problems set by this uncommon clinical picture are considered. The cause of the increase in CPK and MBCPK concentrations, reflecting myolysis, is discussed.

Adult↗
PubMed1984

Acute renal failure due to leptospirosis: clinical features and outcome in six cases.

Six cases of severe leptospiral infection with renal failure are described. Five of the six patients had acute oliguric renal failure requiring dialysis. Renal function recovered over three weeks and by two months all patients had plasma creatinine levels less than 200 mumol/litre. The initial diagnosis of leptospirosis depended on clinical and epidemiological features because serological confirmation was not possible during the first week of the illness. All the patients had either high risk occupations or a history of exposure to external sources of infection. All had fever, myalgia, jaundice and muscle tenderness. Although bilirubin levels were high (greater than 350 mumol/litre in five) the elevations of aspartate transaminase and alkaline phosphatase levels, and prolongations of prothrombin times were relatively slight. Thrombocytopenia occurred in five of the six cases. Leptospira complement fixation tests were weakly positive or negative on admission in five cases but rose to significant levels subsequently. Penicillin treatment resulted in Jarisch-Herxheimer reactions in three cases. The important complications were: upper gastro-intestinal haemorrhage (five cases), thrombocytopenia less than 30 000 platelets/mm3 (four cases), atrial fibrillation (three cases), drowsiness with asterixis (four cases). All six patients were seriously ill and required intensive supportive therapy. All survived.

Acute Kidney Injury↗