Related Experiment Videos
Leptospirosis of the lung: radiographic findings in 58 patients
1Department of Radiology, College of Medicine, Seoul National University, Korea.
Abstract:
Leptospirosis is the disease produced by any of the group of spirochetes of the genus Leptospira. The main organs involved are the liver, central nervous system, kidneys, skeletal muscle, and lungs. Thirty-seven (64%) of 58 patients with leptospirosis, proved by positive serology, had pulmonary radiographic findings. Three radiographic patterns were evident: (1) 21 (57%) of the 37 patients had small nodular densities, (2) six (16%) had large confluent areas of consolidation, and (3) 10 (27%) had diffuse, ill-defined, ground-glass density. Serial radiographs showed a tendency for the nodular pattern to be followed by confluent consolidation and/or ground-glass density. Abnormalities were bilateral, nonlobar in all cases, and had a marked tendency toward peripheral predominance. Pulmonary abnormalities resolved within 15 days, except in eight patients who died because of respiratory failure (six patients) or other causes (two patients). In order to correlate pathology with the radiographic findings, Leptospira, isolated from a patient, was injected intraperitoneally into 20 guinea pigs. All lungs from the guinea pigs showed petecheal hemorrhage, which progressed to large confluent areas of hemorrhage. The typical pulmonary radiographic findings of leptospirosis are compatible with the multifocal pulmonary hemorrhage seen in the guinea pigs.
Insights
Pulmonary radiographic findings in leptospirosis include nodular densities, consolidation, and ground-glass opacities. These findings in patients correlate with multifocal pulmonary hemorrhage observed in guinea pig models.
Area of Science:
- Infectious Diseases
- Radiology
- Pathology
Background:
- Leptospirosis is a zoonotic disease caused by Leptospira spirochetes, affecting multiple organs including the lungs.
- Pulmonary involvement is a significant manifestation of leptospirosis, with varying radiographic presentations.
- Understanding the radiographic patterns is crucial for diagnosis and management.
Purpose of the Study:
- To describe and categorize the pulmonary radiographic findings in patients with leptospirosis.
- To correlate radiographic patterns with pathological findings in an animal model.
- To elucidate the relationship between Leptospira infection and lung abnormalities.
Main Methods:
- Retrospective analysis of chest radiographs from 58 serologically confirmed leptospirosis patients.
- Classification of radiographic patterns into nodular densities, consolidation, and ground-glass opacities.
- Intraperitoneal injection of Leptospira into 20 guinea pigs to induce and study pulmonary pathology.
Main Results:
- Pulmonary radiographic findings were present in 64% (37/58) of patients.
- Common patterns included small nodular densities (57%), large confluent consolidation (16%), and diffuse ground-glass density (27%).
- Animal model demonstrated multifocal pulmonary hemorrhage consistent with observed human radiographic findings.
Conclusions:
- Leptospirosis commonly presents with diverse pulmonary radiographic abnormalities.
- The observed radiographic patterns are consistent with multifocal pulmonary hemorrhage.
- Radiographic findings can evolve over time, and severe cases may lead to respiratory failure.