Department of Internal Medicine, Division of Nephrology, School of Medicine, Hospital Universitário Walter Cantídio, Universidade Federal do Ceará - UFC. Fortaleza, Ceará, Brazil.
Braz J Infect Dis. 2010 Jan-Feb;14(1):3-10.
leptospirosis is a zoonosis of worldwide importance. The disease is endemic in Brazil. This study was conducted to describe the clinical and laboratory presentation of leptospirosis in a metropolitan city of Brazil.
this is a retrospective study including 201 consecutive patients with leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil, between 1985 and 2006. All patients had clinical and epidemiological data suggestive of leptospirosis, and positive laboratorial test for leptospirosis (microscopic agglutination test, MAT, higher than 1:800).
a total of 201 patients were included, with mean age of 38.9 + or - 15.7 years; 79.1% were male. The mean length from onset of symptoms to admission was 7 + or - 3 days. The main clinical signs and symptoms at admission were fever (96.5%), jaundice (94.5%), myalgia (92.5%), headache (74.6%), vomiting (71.6%) and dehydration (63.5%). Hemorrhagic manifestations were present in 35.8%. Acute kidney injury was found in 87% of the patients. Platelet count was less than 100,000/mm(3) in 74.3%. Hematuria was found in 42.9%. Death occurred in 31 cases (15.4%).
leptospirosis is a globally relevant disease with potential fatal outcome. Signs and symptoms suggestive of leptospirosis must be known by any physician in order to institute early adequate treatment to improve outcome. Early indication and daily hemodialysis seems to be beneficial in this group of patients.
钩端螺旋体病是一种具有世界范围重要性的人畜共患病。该疾病在巴西流行。本研究旨在描述巴西一个大都市的钩端螺旋体病的临床和实验室表现。
这是一项回顾性研究，纳入了 1985 年至 2006 年间巴西福塔雷萨的三家三级医院收治的 201 例连续确诊的钩端螺旋体病患者。所有患者均具有临床和流行病学资料提示钩端螺旋体病，并且实验室检测结果为钩端螺旋体病阳性（显微镜凝集试验，MAT，滴度高于 1:800）。
共纳入 201 例患者，平均年龄为 38.9 ± 15.7 岁；79.1%为男性。从症状出现到入院的平均时间为 7 ± 3 天。入院时的主要临床体征和症状为发热（96.5%）、黄疸（94.5%）、肌痛（92.5%）、头痛（74.6%）、呕吐（71.6%）和脱水（63.5%）。35.8%存在出血表现。87%的患者存在急性肾损伤。血小板计数＜100,000/mm³的患者占 74.3%。血尿见于 42.9%的患者。31 例患者死亡（15.4%）。
钩端螺旋体病是一种具有潜在致命后果的全球性重要疾病。任何医生都应了解提示钩端螺旋体病的体征和症状，以便及早进行适当的治疗，改善预后。早期指征和每日血液透析似乎对这组患者有益。
