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Serial Changes in Complete Blood Counts in Patients with Leptospirosis: Our Experience
Deepa Sowkur Anandarama Adiga1, Salony Mittal2, Harini Venugopal3
1Associate Professor, Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.
Insights
Complete blood counts reveal key indicators for leptospirosis severity. Declining hemoglobin, low platelets, and high white blood cell counts signal severe disease, aiding early intervention and preventing fatalities.
Area of Science:
- Infectious Diseases
- Hematology
Background:
- Leptospirosis, caused by *Leptospira interrogans*, is a global infectious disease with varied symptoms.
- Clinical presentation of leptospirosis often mimics other acute febrile illnesses, posing diagnostic challenges.
Purpose of the Study:
- To investigate serial changes in complete blood counts (CBCs) among leptospirosis patients.
- To identify CBC parameters indicative of disease severity.
Main Methods:
- Retrospective and prospective study of clinical and laboratory data from leptospirosis patients confirmed by ELISA.
- Analysis of CBC changes from admission to discharge using SPSS.
- Statistical analysis included frequency, percentage, mean, median, standard deviation, and Mann-Whitney test (p<0.05 significant).
Main Results:
- Mean hemoglobin levels progressively declined (<12.5 gm/dl) from day 1 to day 7 in both mild and severe leptospirosis.
- Platelet counts were significantly lower (p=0.002) in severe disease (<1,50,000 cells/mm³), showing a declining trend compared to mild cases.
- Total leukocyte counts were significantly higher (p=0.001) in severe leptospirosis patients ( >11,000 cells/m³) from day 4 to day 5.
Conclusions:
- Complete blood count is crucial for monitoring leptospirosis patients.
- Early detection of severe leptospirosis can be achieved through monitoring declining hemoglobin, significant thrombocytopenia, and normal to high total leukocyte counts.
- Timely management based on CBC findings can help prevent mortality.
Introduction:
Leptospirosis is an infectious disease caused by Leptospira interrogans. It is endemic in many parts of the world. The symptoms vary between milder forms to severe type with organ dysfunction. The disease presents with diagnostic challenge as it clinically mimics acute febrile illness due to other causes.
Aim:
To study serial changes in complete blood counts in patients with leptospirosis.
Materials And Methods:
A retrospectively collected data was prospectively studied for clinical and laboratory data of leptospirosis patients proven by raised IgM titres by ELISA on day 2 (counted from day of admission of patient to hospital) of unexplained fever. The changes in complete blood counts from admission upto the discharge of the patient were studied. SPSS version 13 (SPSS Inc. Chicago) was used for data analysis. The collected data was analysed using frequency, percentage, mean, median, standard deviation and Mann-Whitney test. A p-value less than 0.05 were considered significant.
Results:
Mean haemoglobin concentration showed a progressive decline (<12.5 gm/dl) from day 1 to day 7 in both mild and severe disease. Platelet counts were significantly low (p=0.002), (<1,50,000 cells/mm3) in severe disease and showed a declining trend as compared to mild disease. Total leukocyte counts were significantly higher (p=0.001), (>11,000 cells/m3) in patients with severe disease from day 4 to day 5 of the illness.
Conclusion:
Complete blood count is a routine test done in the monitoring of patients with leptospirosis. Declining haemoglobin, marked thrombocytopenia and a normal to high total leukocyte count will help in early detection of severe disease and thus preventing mortality by timely management.
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