OBJECTIVE: Analysis of risk factors associated with severity in patients with confirmed leptospirosis. DESIGN AND SETTING: Retrospective study in 147 leptospirosis-confirmed patients at two tertiary nonteaching hospital in Reunion Island. PATIENTS: 138 men and 9 women, aged 36+/-14 years, 80 in the ICU and 67 in medical wards. MEASUREMENTS AND RESULTS: We collected demographic, clinical, biological, and radiographic data and performed univariate and multivariate analysis to examine risk factors associated with admission in ICU and mortality. Pulmonary forms were more frequent (85%) than in previous reports, with 85 cases (65.3%) on abnormal chest radiography. Among the 38 patients who underwent bronchoalveolar lavage at admission 31 (81.5%) had alveolar hemorrhage. Independent factors related to ICU admission were: age over 46[Symbol: see text]years (OR 3.02), creatinine higher than 200[Symbol: see text]mumol/l (6.69), shock (13.87), and acute respiratory failure (20.69). Mortality was 12.9%. The only factor independently related to mortality was need for mechanical ventilation (OR 20.94). Icterohemorrhagiae serogroup was found in 62 cases (42.8%) but was not related to death. CONCLUSIONS: Pulmonary involvement is a major feature in leptospirosis disease but is not associated with poor outcome. Identification of clinical and laboratory findings on admission may help to better characterize severe cases.
OBJECTIVE: Analysis of risk factors associated with severity in patients with confirmed leptospirosis. DESIGN AND SETTING: Retrospective study in 147 leptospirosis-confirmed patients at two tertiary nonteaching hospital in Reunion Island. PATIENTS: 138 men and 9 women, aged 36+/-14 years, 80 in the ICU and 67 in medical wards. MEASUREMENTS AND RESULTS: We collected demographic, clinical, biological, and radiographic data and performed univariate and multivariate analysis to examine risk factors associated with admission in ICU and mortality. Pulmonary forms were more frequent (85%) than in previous reports, with 85 cases (65.3%) on abnormal chest radiography. Among the 38 patients who underwent bronchoalveolar lavage at admission 31 (81.5%) had alveolar hemorrhage. Independent factors related to ICU admission were: age over 46[Symbol: see text]years (OR 3.02), creatinine higher than 200[Symbol: see text]mumol/l (6.69), shock (13.87), and acute respiratory failure (20.69). Mortality was 12.9%. The only factor independently related to mortality was need for mechanical ventilation (OR 20.94). Icterohemorrhagiae serogroup was found in 62 cases (42.8%) but was not related to death. CONCLUSIONS: Pulmonary involvement is a major feature in leptospirosis disease but is not associated with poor outcome. Identification of clinical and laboratory findings on admission may help to better characterize severe cases.
Authors: Ajay R Bharti; Jarlath E Nally; Jessica N Ricaldi; Michael A Matthias; Monica M Diaz; Michael A Lovett; Paul N Levett; Robert H Gilman; Michael R Willig; Eduardo Gotuzzo; Joseph M Vinetz Journal: Lancet Infect Dis Date: 2003-12 Impact factor: 25.071
Authors: H P Salkade; S Divate; J R Deshpande; V Kawishwar; R Chaturvedi; B M Kandalkar; P Vaideeswar Journal: J Postgrad Med Date: 2005 Jul-Sep Impact factor: 1.476
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Johan Groeneveld; Goran Hedenstierna; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Philipp Metnitz; Jerme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2008-01-31 Impact factor: 17.440
Authors: Anne S Spichler; Pedro J Vilaça; Daniel A Athanazio; Jose O M Albuquerque; Marcia Buzzar; Bronislawa Castro; Antonio Seguro; Joseph M Vinetz Journal: Am J Trop Med Hyg Date: 2008-12 Impact factor: 2.345
Authors: Paulo C F Marotto; Albert I Ko; Cristiane Murta-Nascimento; Antonio C Seguro; Rogerio R Prado; Marcia C Barbosa; Sergio A Cleto; José Eluf-Neto Journal: J Infect Date: 2009-12-21 Impact factor: 6.072
Authors: Bodo Hoffmeister; Gabriele Peyerl-Hoffmann; Sven Pischke; Ines Zollner-Schwetz; Robert Krause; Matthias C Müller; Angelika Graf; Stefan Kluge; Gerd D Burchard; Winfried V Kern; Norbert Suttorp; Jakob P Cramer Journal: Am J Trop Med Hyg Date: 2010-08 Impact factor: 2.345
Authors: Frederik Staikowsky; François Talarmin; Philippe Grivard; Abdel Souab; Isabelle Schuffenecker; Karin Le Roux; Marc Lecuit; Alain Michault Journal: PLoS One Date: 2009-10-28 Impact factor: 3.240