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Changes in full blood count parameters in leptospirosis: a prospective study.
Nipun Lakshitha De Silva1, Mjr Niloofa2, Narmada Fernando2
1Tropical Medicine Research Unit, Faculty of Medicine, University of Colombo, 25 Kynsey Road, Colombo 08, Sri Lanka.
International Archives of Medicine
|July 15, 2014
Summary
Leptospirosis often presents with normal white blood cell counts initially, but thrombocytopenia and falling hemoglobin levels are common. High neutrophil counts and low hemoglobin may indicate severe disease.
Area of Science:
- Infectious Diseases
- Hematology
- Clinical Diagnostics
Background:
- Leptospirosis diagnosis is challenging in febrile illness settings.
- Serial hematological parameter changes in leptospirosis remain unevaluated.
Purpose of the Study:
- To evaluate serial changes in hematological parameters in leptospirosis patients.
- To identify hematological markers that may predict severe leptospirosis.
- To aid in differentiating leptospirosis from other acute febrile illnesses.
Main Methods:
- Prospective collection of clinical and laboratory data from 201 leptospirosis patients in Sri Lanka.
- Leptospirosis diagnosis confirmed by WHO criteria and Microscopic Agglutination Test.
- Analysis of full blood count parameters up to day 14 of illness.
Main Results:
- Leukocyte and neutrophil counts initially declined then rose; leukocytosis was uncommon early on.
- Lymphopenia was observed in over half of patients by day 5.
- Thrombocytopenia affected nearly three-fourths of patients by day 5, with gradual platelet count recovery.
- Hemoglobin and hematocrit levels decreased during illness.
- Severe leptospirosis cases showed higher white cell/neutrophil counts and lower hemoglobin/hematocrit.
Conclusions:
- Thrombocytopenia (days 3-5) and falling hemoglobin are key findings.
- Neutrophilia and low hemoglobin levels may predict severe leptospirosis.
- These hematological patterns can assist clinicians in differentiating leptospirosis from dengue and predicting disease severity.
