Association of Pulmonary Manifestations in Leptospirosis: A Cross-Sectional Study

The symptoms of leptospirosis can range from mild pulmonary symptoms to acute respiratory distress syndrome (ARDS) and lung hemorrhage. As a result, a delayed diagnosis may have negative consequences. A cross-sectional study was conducted to determine the prevalence and spectrum of pulmonary manifestations in leptospirosis.

This cross-sectional study was conducted among patients admitted with febrile illness and diagnosed with leptospirosis by IgM anti-leptospiral antibodies. Clinical features, with special focus on pulmonary complaints, were recorded using a questionnaire. Presentations such as jaundice, oliguria, cough, hemoptysis, breathlessness, chest pain, evidence of ARDS, and pulmonary hemorrhage were noted. Chest X-rays were assessed for the presence of reticular infiltration and airspace nodules. The data were subjected to statistical analysis.

The study included 50 patients (aged 18 to 80 years) who had been diagnosed with leptospirosis. Among the 50 patients, 42 (84%) were male; the mean age of the patients was 43.7 years. All patients experienced fever, followed by myalgia, which was noted in 45 (90%) patients. In 22 (44%) patients, pulmonary symptoms - including cough, breathlessness, and hemoptysis - were identified. Abnormal chest X-rays were noted in 10 (20%) patients, and the most common pattern that increased the likelihood of requiring artificial breathing was airspace nodules. Tachypnea and hemodynamic impairment were two parameters that significantly correlated with abnormal chest X-rays. There were 16 deaths, with the leading cause of death being pulmonary problems in 13 patients (81.25%), followed by acute renal failure in two patients (12.5%) and multi-organ dysfunction in one patient (6.25%).

Leptospirosis frequently manifests as pulmonary symptoms, which are linked to a high death rate. Reducing mortality requires early detection and treatment.