Clerke A M, Leuva A C, Joshi C, Trivedi S V
Department of Medicine, Government Medical College, Surat - 395 001, Gujarat, India.
J Postgrad Med. 2002 Apr-Jun;48(2):117-8.
South Gujarat has been witnessing increasing incidence of leptospirosis for the last few years.
To study the clinical profile of leptospirosis in South Gujarat.
Prospective study during July-September 2000 at the New Civil Hospital, Surat, Gujarat.
All the consecutive cases with clinical suspicion of leptospirosis were screened for lgM antileptospira antibody on the first and the fourteenth day. A four fold or greater increase in agglutinin antibody titre on paired samples was considered diagnostic. If the patient died before the fourteenth day then initial titre greater than 1:15 was considered diagnostic.
Total number of patients referred to the hospital were fifty, of which thirty-eight [33 males, with age 14-50 (30 +/- 10.51)] were diagnosed as having leptospirosis. Most common organs involved were liver (27, 71.05%) and kidney (24, 63.15%). Cardio-vascular (12, 31.5%), pulmonary (10, 26.35%), neurological (2, 5.26%) and haematological (8, 21%) involvements were less common. Six patients died because of pulmonary involvement in the form of alveolar haemorrhage, while one died because of cardiac involvement.
Liver and kidney were the most commonly involved organs in severe leptospirosis. Pulmonary involvement, though uncommon, led to high mortality.
在过去几年中，古吉拉特邦南部地区钩端螺旋体病的发病率一直在上升。
研究古吉拉特邦南部地区钩端螺旋体病的临床特征。
2000年7月至9月在古吉拉特邦苏拉特市新市民医院进行的前瞻性研究。
对所有临床怀疑为钩端螺旋体病的连续病例在第1天和第14天进行IgM抗钩端螺旋体抗体筛查。配对样本中凝集素抗体滴度增加四倍或更多被认为具有诊断意义。如果患者在第14天前死亡，则初始滴度大于1:15被认为具有诊断意义。
转诊至该医院的患者总数为50例，其中38例[33例男性，年龄14 - 50岁（30 ± 10.51）]被诊断为钩端螺旋体病。最常受累的器官是肝脏（27例，71.05%）和肾脏（24例，63.15%）。心血管系统（12例，31.5%）、肺部（10例，26.35%）、神经系统（2例，5.26%）和血液系统（8例，21%）受累较少见。6例患者因肺泡出血形式的肺部受累死亡，1例因心脏受累死亡。
在严重钩端螺旋体病中，肝脏和肾脏是最常受累的器官。肺部受累虽然不常见，但导致了高死亡率。
