Title: Clinical Profile of Leptospirosis in Khammam
Authors: Venkatesh Garlapati, Dilip M Rampure, G Rajashekarappa, Goutham Vidyam
DOI: http://dx.doi.org/10.18535/jmscr/v3i10.16
BACKGROUND: In the last few decades infectious diseases like leptospirosis have re-emerged and are on the rise. With other infectious diseases like Malaria, Dengue, Infective hepatitis which simulate leptospirosis being rampant, there is a need to know the clinical profile, complications of leptospirosis particularly from this part of the country. OBJECTIVES: The present study was undertaken to understand the clinical profile, laboratory findings and complications of leptospirosis. METHODS: Fifty patients who were positive for IgM anti leptospiral antibodies in Mamata General Hospital were subjected to detailed history, clinical examination, investigations and followed up till discharge or death. They were treated as per protocol, clinical data was tabulated. Statistical analysis was done. RESULTS: Dark Ground Microscopy of urine was positive for leptospira in 58% patients. The age groupcommonly involved was 20-39 years(58%). Most of the patients were males (76%), with occupation involving outdoor activity(66%). Common symptoms encountered were fever, musculoskeletal, jaundice and oliguria. Less commonly seen were bleeding, gastrointestinal symptoms, respiratory symptoms and altered sensorium. Important signs seen were conjunctival suffusion, hepatomegaly, hypotension, splenomegaly. Hyperbilurubinemia was predominantly of conjugated type and elevation of transminases was mild to moderate. Mean bilurubin was 4.67mg/dl. Mean SGOT was 99.23U/L and SGPT was 96.97U/L. AKI was seen in 46% and six of them needed Hemodialysis. Thrombocytopenia was seen in 56% patients.40% had multiorgan failure, 4% had aseptic meningitis, 2% had ARDS, 2% had GI hemorrhage. CONCLUSION; A high degree of clinical suspicion is the key to diagnosis ofleptospirosis. Fever and musculoskeletal features are most common symptoms. Conjunctival suffusion is a common finding. Liver and kidney are common organs involved. Multi Organ Failure was significantly associated with mortality (p<.05). Thrombocytopenia was significantly related to clinical bleeding (p<.001)
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