Radiographic chest findings and clinical correlations in leptospirosis.

OBJECTIVE

To determine the clinical presentations, radiographic chest findings, and their correlation in patients with leptospirosis.

DESIGN

A cross sectional study.

SETTING

Between July 2001- December 2002 at 3 hospitals in North Eastern Thailand.

MATERIAL AND METHOD

Two hundred and forty patients with laboratory confirmed leptospirosis.

RESULTS

Two hundred and nine (87.1%) patients were males. The mean age was 37.53 years (range 13-76). The median duration of fever was 3 days (range 1-13). Overall, 154 patients (64.2%) had respiratory symptoms and 26 (10.8%) patients had hemoptysis. Jaundice was detected in 76 (31.7%) patients, hypotension in 50 (20.8%), renal dysfunction in 80 (30%), and multiorgan dysfunction in 62 (25.8%) on admission. One hundred and fifty-four (64.17%) patients had abnormal chest radiographs on admission (classified as cardiovascular, pulmonary, and mixed cardio-pulmonary involvement in 40 (25.97%), 41 (26.62%), and 73 (47.4%) patients, respectively). Jaundice was significantly associated with the likelihood of having abnormal chest radiography on admission. Air- space nodules detected on the chest radiograph were significantly more common in patients with renal dysfunction and patients who required mechanical ventilation.

CONCLUSION

Pulmonary and cardiovascular involvements are common in leptospirosis. Air-space nodules detected by chest radiography may indicate severe leptospirosis.