Rodríguez-Villamarín Flor R, Prieto-Suárez Edgar, Escandón Patricia L, de la Hoz Restrepo Fernando
Instituto Nacional de Salud, Bogotá, Colombia,
Universidad Nacional de Colombia, Bogotá, Colombia,
Rev Salud Publica (Bogota). 2014 Jul-Aug;16(4):597-609.
Using the microscopic agglutination test (MAT) from 2010-2012 for identifying leptospirosis-related and sociodemographic variables in patients having a confirmed diagnosis of dengue and those for whom it had been discarded.
This was a retrospective study of 238 sera samples. 106 patients died, 64 of their samples were negative for dengue and 42 proved positive. 132 samples from live patients proved positive for dengue; 29 were confirmed by PCR and/or virus isolation and 103 had positive IgM readings. MAT was used for all sera and diagnosing Leptospira, epidemiological records were reviewed and the data was analysed.
42 dengue positive patients died; 3 (7%) were positive for Leptospira interrogans sero group Australis autumnalis (two girls aged 5 and 17 years-old and a 14 year-old boy). Of the 64 deceased patients who proved negative for dengue, 7 (11%) were found positive for L.interrogans from sero groups Pomona, Autumnalis, Canicola and Ballum (5 males aged 8 to 58 years-old and 2 women aged 35 and 56 years-old). Of the 103 living patients who proved positive for dengue IgM, 3 (2.9%) were positive for Leptospira icterohaemorrhagiae from the Cynopteri, Javanica Proechimys and Autumnalis sero groups(1 male and 2 females). None of the 29 living patients confirmed as having dengue were positive for Leptospira.
Leptospirosis should be suspected not only as the sole causative agent of febrile syndrome but also of co-infection which could compromise a patient and be related to mortality.
利用2010 - 2012年的显微镜凝集试验（MAT），在确诊登革热患者及排除登革热诊断的患者中识别与钩端螺旋体病相关的变量和社会人口统计学变量。
这是一项对238份血清样本的回顾性研究。106例患者死亡，其中64例样本登革热检测为阴性，42例检测为阳性。132例存活患者的样本登革热检测为阳性；29例通过PCR和/或病毒分离确诊，103例IgM读数为阳性。对所有血清样本进行MAT检测以诊断钩端螺旋体，查阅流行病学记录并分析数据。
42例登革热阳性患者死亡；3例（7%）问号钩端螺旋体澳洲秋季血清群检测为阳性（两名5岁和17岁女孩以及一名14岁男孩）。在64例登革热检测为阴性的死亡患者中，7例（11%）波摩那、秋季、犬型和拜伦血清群的问号钩端螺旋体检测为阳性（5名年龄在8至58岁的男性和2名35岁和56岁的女性）。在103例登革热IgM检测为阳性的存活患者中，3例（2.9%）来自犬蝠、爪哇、长吻松鼠和秋季血清群的出血性黄疸钩端螺旋体检测为阳性（1名男性和2名女性）。29例确诊为登革热的存活患者中无一例钩端螺旋体检测为阳性。
不仅应怀疑钩端螺旋体病是发热综合征的唯一病原体，还应怀疑其为可能危及患者并与死亡率相关的合并感染病原体。
