Leptospirosis: clinical presentation and correlation with serovars

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Leptospirosis is a significant zoonotic disease presenting with diverse clinical manifestations.
• Pyrexia of unknown origin (PUO) often necessitates investigation for infectious etiologies like leptospirosis.

Purpose of the Study:

• To determine the prevalence and clinical spectrum of leptospirosis in patients with PUO or suspected infection.
• To identify causative Leptospira serovars and associated co-infections.
• To evaluate treatment responses and outcomes in leptospirosis patients.

Main Methods:

• A cohort of 2400 patients with PUO or suspected leptospirosis was studied.
• Diagnostic methods included dark field microscopy and Leptospira serological investigations (Microscopic Agglutination Test - MAT).
• Clinical presentations, co-infections (Hepatitis B Virus, HIV), and treatment outcomes were recorded.

Main Results:

• Leptospira was detected in 690 patients by microscopy, with 570 confirmed serologically.
• Leptospira interrogans serovar icterohemorrhagiae caused infection in 212 patients; serovar cannicola was linked to 30 cases of multi-organ dysfunction.
• Co-infections with Hepatitis B virus (15 patients) and HIV (30 of 330 anicteric patients) were observed. 554 patients responded to antibiotics (penicillin, doxycycline, augmentin), while 16 died.

Conclusions:

• Leptospirosis is a common cause of PUO, with varied clinical presentations and significant morbidity.
• Early diagnosis and appropriate antibiotic treatment are crucial for managing leptospirosis and improving patient outcomes.
• The study highlights the importance of considering leptospirosis in endemic areas, especially in patients with PUO and specific risk factors.