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At least 973 records · Page 54Linked to original sources
PubMed1999

Risk factors for death and changing patterns in leptospirosis acute renal failure.

The risk factors for death and changes in clinical patterns in leptospirosis (Weil's disease) have not been well studied. We retrospectively studied 110 patients with Weil's disease hospitalized in Brazil between 1985 and 1996. Univariate statistical analysis showed that nonsurvivors were older than survivors, and had higher frequency of oliguria, cardiac arrhythmia, dyspnea, and pulmonary rales. Logistic regression showed that the only independent factor associated with death was oliguria (odds ratio [OR] = 8.98). The presence of arthralgia (OR = 4.71), dehydration (OR = 6.26), dyspnea (OR = 17.7), and pulmonary rales (OR = 9.91) increased after 1994. These data suggest that in Weil's disease the clinical patterns have changed and the presence of oliguria is a risk factor for death.

Acute Kidney Injury↗
PubMed1987

Serologic survey for evidence of exposure to vesicular stomatitis virus, pseudorabies virus, brucellosis and leptospirosis in collared peccaries from Arizona.

Two hundred eighteen usable serum samples were collected from hunter-killed collared peccaries (Tayassu tajacu) during March 1986, in three areas of Arizona. Evaluations for antibodies against vesicular stomatitis virus (VSV) New Jersey (NJ) type, VSV Indiana type, pseudorabies virus, brucellosis, and leptospirosis revealed positive test results in 8%, 0%, less than 1%, 0%, and 23% of the sera, respectively. Exposure of peccaries to VSV (NJ) was widespread, but variation in the prevalence of seropositive peccaries was not found between the three areas sampled. The exposure of peccaries to VSV (NJ) probably was related to the recent epizootics in livestock in the vicinity. Exposure to Leptospira interrogans serovars also was widespread, and geographic variation in the prevalence of peccaries with antibodies against L. interrogans was found.

Animals↗
PubMed1998

[The clinical aspects of discrete plasmapheresis in treating multiple organ failure in patients with the icterohemorrhagic form of leptospirosis].

Discrete-mode plasmapheresis using medium doses of separated plasma provides a detoxicating effect by eliminating of toxins, products of catabolism, biologically active substance, stimulation of gastrointestinal functions and cardiovascular system. Clinical application of plasmapheresis in a combined treatment of leptospirosis icterohaemorrhagica under multiorgan failure offers a highly efficient therapeutic alternative in alleviating the condition.

Acute Disease↗
PubMed1999

[The pathomorphology and pathogenetic problems of liver involvement in icterohemorrhagic leptospirosis].

Morphologic findings on the liver during different time periods of Leptospira infection suggest the leading role in the pathogenesis of the damaged organ early in the course of the disease of a toxic vascular affection of the microcirculatory bed presenting with hyperpermeability of the vascular wall, interstitial edema, dyscomplexation of the liver crosspieces together with inflow of bile to the sinusoidal capillaries. To a lesser extent jaundice is related to the hepatocyte dystrophic and necrotic changes as evidenced by the absence of marked disturbances in the protein-synthetizing function of the liver and low enzymatic activity. At week 2 to 3 of the illness against the background of diminution of the edema and partial or complete restoration of the liver constitution (especially so in less afflicted peripheral portions of the lobes) jaundice with high bilirubinemia is caused by a toxic affliction of hepatocytes and advancing centrolobular cholestasis. High values for bilirubin might be related not only to grave alternative changes in hepatocytes but to microcirculatory abnormalities as well, which fact accounts for the absence in leptospirosis of a direct relationship of the blood level of bilirubin to the degree of affliction of the hepatic cells.

Humans↗
PubMed1999

[The clinical aspects of acute liver failure in leptospirosis].

Acute hepatic insufficiency is the main link in the pathological process in leptospirosis determining the degree of severity of the condition and level of bodily compensatory potentialities. Pathogenetically, hepatic insufficiency runs its course through the following three stages: compensated, sub-compensated, and decompensated characterized by different levels of functional (excretory-biliary, protein-synthetizing, hemostatic, detoxicating) inadequacy.

Adolescent↗
PubMedDate not supplied

[Care of a patient with leptospirosis icterohemorrhagica].

Leptospirosis is an acute generalized infectious disease caused by a spirochete of the genus Leptospira. Humans become infected by direct contact with the animal reservoir or indirectly through standing water or contaminated wet areas; once the leptospira has entered the body through the mucosa or eroded skin, it is spread by blood circulation. It can cause hepatic, renal and muscular disorders, as well as meningeal inflammation. We report the case of a patient admitted to the ICU for an infectious process produced by leptospira. Complications are described and identified as nursing problems and/or diagnoses. Following the NANDA nomenclature, the diagnoses were: Tissue-perfusion disturbance. Deterioration of gas exchange. Deterioration of verbal communication. Nutritional disorder. These categories enabled specific nursing interventions to be planned for the patient's care. The patient died of multiple organ failure in spite of conventional care and treatment.

Acute Disease↗
PubMed1975

Acute renal failure due to leptospirosis with hyponatraemia.

Severe forms of leptospirosis causing acute renal failure are uncommon in Australia. Reported here is one such case, with marked hyponatraemia, which was treated with peritoneal dialysis. Biopsy findings are presented. It is believed that the infection was acquired in suburban periodomestic surroundings.

Acute Disease↗
PubMed2002

[Respiratory distress due to pulmonary hemorrhage in leptospirosis].

Two patients who lived in Buenos Aires suburbs died from leptospirosis in July 2000 and March 2001. They developed a nonspecific febrile illness followed by hemorrhagic pneumonia and respiratory distress in absence of typical manifestations such as jaundice, nephropathy, thrombocitopenia or hemorrhages in other organs. In the house and surroundings of one patient rodents were captured and three strains of leptospira, serogroup Icterohaemorrhagiae were isolated. Laboratory guinea pigs were inoculated and they were sacrificed as soon as respiratory symptoms appeared. Necropsy showed primary lung injury, which was similar to the histopathological lesions found in one of the patients. Neither jaundice, nor renal damage was found. Pericardiac hemorrhages were considered as a possible cause of cardiopulmonary collapse. This clinical form has not been reported previously in this region, where conditions are indeed suitable for the human illness to appear.

Adult↗
PubMed2003

[Outcome and tendency of late convalescence in icterohemorrhagic leptospirosis].

To elucidate the time of onset and duration of complications of icterohemorrhagic leptospirosis (IL), a clinical course of early and late convalescence was analysed in 170 patients who were followed up for 1.5-9 years. It was found that affection of hepatobiliary, urinary, cardiovascular and nervous systems persisted for a year after the acute disease in 65.3, 67.6, 31.8 and 13.5% patients, respectively. The organ of vision was affected for 1 year in 7.1% patients. A total of 86% patients retained the above disorders in early convalescence (for a year). In early convalescence the author observed development of such diseases as chronic hepatitis, a latent stage of chronic renal failure, myocardiac myocardiodystrophy. Nervous and ocular complications manifested both in early and late convalescence (4-18 months). The complications combined in 66.0% cases, renal dysfunction + hepatic dysfunction being most frequent. Endogenic infection foci activated within 6 months after IL. In 19.4% patients, the pathological process prolonged up to 1.5 years. In 5.3% patients it can last for several years. It is concluded that IL patients should be followed up for 1.5 years, combined pattern of organ affection typical for IL should be taken into account.

Adolescent↗
PubMed1992

[Detection of leptospiral DNA in the serum of 175 patients with early leptospirosis by polymerase chain reaction].

We have developed a sensitive assay for leptospira, using the polymerase chain reaction (PCR). On the basis of the published nucleotides sequence of 23S rRNA gene from Leptospira interrogans serovar canicola strain Moulton, primers were chosen to produce an amplified fragment of 123 bp. Primer A: 5'GAT CTA ATT CGC TGT AGC AGG3' and primer B: 5'ACT TTC ACC CTC TAT GGT CGG3' Eight different svs. of Leptospira interrogans could all be detected by PCR, but the DNAs from L. biflexa. Leptonema bacteria, virus and human could not produce the specific amplified fragment. The assay detected approximately 10 fg of purified leptospiral DNA and 1 microliter serum of experimental animal. Positive results were obtained from simulated positive samples containing a single organism leptospiral DNA. The diagnostic test (proved by "gold standards": Clinical diagnosis; blood culture and MAT) showed that the sensitivity was 92.00%; the specificity 94.35%; the accuracy 92.54%; the positive predictive value 98.17%; the negative predictive value 78.13%; the positive likelihood ratio 16.25; and the negative likelihood ratio 0.0848. The diagnosis of early leptospirosis by using PCR may become a significant addition to diagnostic means.

Animals↗
PubMedDate not supplied

[The early diagnosis of leptospirosis by demonstrating antigens via an immunohistochemical exam of the hamstring muscle].

Establishing an early and certain diagnosis of leptospirosis has been a difficult task. So, we analysed the histopathological alterations of the gastrocnemius muscle, and studied, for the first time, the usefulness of the immune histochemical method of peroxidase-antiperoxidase for the demonstration of the spirochete and of its products in this tissue. Histopathological observations have shown a picture of myositis, characterized by interstitial inflammatory infiltrate and necrotic-degenerative abnormalities of muscle fibers. The lesions were considered minimal in 69.45% of the patients, moderate in 19.45%, severe in 5.55% and absent in the remaining. On the other hand, the immune histochemical method identified the etiology in 94.45% what was considered very expressive.

Adolescent↗
PubMed2006

[Ictero-haemorrhagic leptospirosis with a cardiac presentation in a patient returning from an endemic zone].

On returning from a tropical area, the occurrence of rapidly evolving cardiogenic shock in an infectious context should quickly suggest the diagnosis, for which specific treatment can affect the outcome. The dramatic case of a young female presenting with ictero-haemorrhagic leptospirosis diagnosed post-mortem, demonstrated this pathology with the unusual association of complete atrio-ventricular block and myocarditis in a haemorrhagic context.

Adult↗
PubMed1991

[Construction of gene bank of L. interrogans serovar lai and cloning of homological sequences of virulent leptospirosis].

A gene bank of the main pathogen of pulmonary diffuse haemorrhage type leptospirosis (PDH), L. interrogans serovar lai strain 017, was first constructed with plasmid vector pUC9, which contained 610 recombinant clones and laid the foundation for further investigation of molecular characteristics of leptospires with strong virulence. Recombinant plasmids which have homological sequences of pathogenic leptospires were screened from the gene bank. A recombinant plasmid, designated pCX7, could detect 1.7 kb fragment of strain 017, 9.0 kb of strain 601 and 30.0 kb of strain 610 respectively without cross hybridization with nonvirulent leptospires such as L. biflexa strain Patoc I and Leptonema illini. pCX9, another recombinant plasmid, could detect 1.9 kb fragment of strain 017 and had no hybridization with other pathogenic or nonpathogenic leptospires. The results showed that the degree of homology between pathogenic and non-pathogenic leptospires was very low and the degree of homology was very high among the pathogenic leptospires.

Cloning, Molecular↗
PubMed1991

[Icterohemorrhagic leptospirosis with acute respiratory distress syndrome and pulmonary hemorrhage].

We report a case of the respiratory distress syndrome occurring in a patient with leptospirosis ictero-haemorrhagica (LIH). The respiratory failure was associated with pulmonary haemorrhage. There was a rapid favourable outcome after treatment with antibiotics and artificial ventilation. The diagnosis of LIH has been confirmed by serological examination. The mechanisms of the pulmonary disorder during the course of LIH were discussed.

Adult↗
PubMed1991

[Leptospirosis in swine; observations on the serological diagnosis of Leptospira interrogans serotype bratislava].

Leptospirosis is considered to be an important cause of porcine reproductive failure. In this respect recently attention is paid to the possible role of Leptospira interrogans serotype bratislava (bratislava). In the present paper the results of serotype bratislava serology conducted on three farms are presented and discussed. On two of the farms no reproductive failure was observed. On the third farm with a high percentage of return to service a longitudinal search was done. No relation could be demonstrated between bratislava titers and reproductive failure.

Animals↗
PubMed1991

[The treatment of leptospirosis complicated by severe liver-kidney failure].

The authors examined 16 patients with severe forms of leptospirosis complicated by hepato-renal insufficiency. The treatment program included the following methods: hemodialysis, hemosorption, intraportal administration of drugs, gastrointestinal sorption via a heterospleen, hyperbaric oxygenation. As a result of this complex treatment lethality decreased by 15%.

Acute Disease↗
PubMedDate not supplied

[High resolution light microscopy: adaptation of the method and its use in the study of experimental leptospirosis in guinea pigs].

Morphological lesions in parenchimal and mesenchimal structures of liver and kidney were studied in guinea-pigs experimentally infected with Leptospira interrogans serogroup icterohaemorrhagiae in comparison with a group of non-infected guinea-pigs. All specimens were submitted to conventional light microscopy as well as to high resolution light microscopy, in one micrometer sections of tissue embedded in glycolmethacrylate. High resolution light microscopy, applied for the first time in leptospirosis, was proved very useful, since it enabled us to visualize cellular structures in the same slide used for panoramic view. Cell cohesion, brush borders, pynocytotic vesicles and organellae distributions were parameters especially suitable for analysis at this low-cost, highly precise procedure in microscopy.

Animals↗