PDF(Pubmed)
Abstract：
Leptospirosis is a rodent-borne acute febrile illness, classically seen after heavy rainfall and floods. This study aimed to describe the clinical profile, management strategies and outcome of patients with leptospirosis amidst the Coronavirus disease-2019 outbreak. A prospective study of adult patients with undifferentiated fever (5-15 days) was conducted in South India between October 2020 and February 2021. The demographic, clinical details, laboratory details, treatment and outcome of leptospirosis positive (based on serology) and negative patients were compared. A chisquare test was used for qualitative variables, while an independent t-test or Mann Whitney U test was used for continuous variables. Of the 206 patients with suspected acute febrile illness, a total of 63 patients were diagnosed with leptospirosis based on serology results. The median sequential organ failure assessment score was higher in those with leptospirosis (p<0.001). Myalgia, abdominal pain, jaundice, decreased urine output, myocarditis, and dialysis requirement were more common in patients with leptospirosis. Leucocytosis and raised procalcitonin/C-reactive protein were more common in patients with leptospirosis. The duration of stay and antibiotic consumption was higher in patients with leptospirosis. Acute febrile illness such as leptospirosis should be suspected in tropical areas with significant risk factors. The presence of conjunctival suffusion, hepatic and renal dysfunction should warrant a serology test for leptospirosis.
摘要：
钩端螺旋体病是一种啮齿动物传播的急性发热性疾病，典型地在暴雨和洪水之后看到。这项研究旨在描述临床概况，2019年冠状病毒病暴发期间钩端螺旋体病患者的管理策略和结局。2020年10月至2021年2月在印度南部进行了一项针对未分化发热（5-15天）成年患者的前瞻性研究。人口统计，临床细节，实验室细节,比较钩端螺旋体病阳性（基于血清学）和阴性患者的治疗和结局。Chisquare检验用于定性变量，连续变量采用独立t检验或MannWhitneyU检验。在206名怀疑急性发热的病人中,根据血清学结果，共有63例患者被诊断为钩端螺旋体病。钩端螺旋体病患者的序贯器官衰竭评估评分中位数较高（p<0.001）。肌痛,腹痛,黄疸,尿量减少,心肌炎,并且需要透析在钩端螺旋体病患者中更为常见。白细胞增多和降钙素原/C反应蛋白升高在钩端螺旋体病患者中更为常见。钩端螺旋体病患者的住院时间和抗生素消耗较高。在具有重大危险因素的热带地区，应怀疑急性高热性疾病，例如钩端螺旋体病。结膜充血的存在，肝和肾功能不全应进行钩端螺旋体病的血清学检查。
