Adiga Deepa Sowkur Anandarama, Mittal Salony, Venugopal Harini, Mittal Sowmya
Associate Professor, Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.
Assistant Professor, Department of Pathology, Kasturba Medical College, Mangalore, Karnataka, India.
J Clin Diagn Res. 2017 May;11(5):EC21-EC24. doi: 10.7860/JCDR/2017/25706.9836. Epub 2017 May 1.
Leptospirosis is an infectious disease caused by . It is endemic in many parts of the world. The symptoms vary between milder forms to severe type with organ dysfunction. The disease presents with diagnostic challenge as it clinically mimics acute febrile illness due to other causes.
To study serial changes in complete blood counts in patients with leptospirosis.
A retrospectively collected data was prospectively studied for clinical and laboratory data of leptospirosis patients proven by raised IgM titres by ELISA on day 2 (counted from day of admission of patient to hospital) of unexplained fever. The changes in complete blood counts from admission upto the discharge of the patient were studied. SPSS version 13 (SPSS Inc. Chicago) was used for data analysis. The collected data was analysed using frequency, percentage, mean, median, standard deviation and Mann-Whitney test. A p-value less than 0.05 were considered significant.
Mean haemoglobin concentration showed a progressive decline (<12.5 gm/dl) from day 1 to day 7 in both mild and severe disease. Platelet counts were significantly low (p=0.002), (<1,50,000 cells/mm) in severe disease and showed a declining trend as compared to mild disease. Total leukocyte counts were significantly higher (p=0.001), (>11,000 cells/m) in patients with severe disease from day 4 to day 5 of the illness.
Complete blood count is a routine test done in the monitoring of patients with leptospirosis. Declining haemoglobin, marked thrombocytopenia and a normal to high total leukocyte count will help in early detection of severe disease and thus preventing mortality by timely management.
钩端螺旋体病是一种由……引起的传染病。它在世界许多地区流行。症状从较轻形式到伴有器官功能障碍的严重类型各不相同。由于该疾病在临床上与其他原因引起的急性发热性疾病相似，因此在诊断上具有挑战性。
研究钩端螺旋体病患者全血细胞计数的系列变化。
对回顾性收集的数据进行前瞻性研究，这些数据是关于经酶联免疫吸附测定（ELISA）在不明原因发热患者入院第2天（从患者入院之日起计算）IgM滴度升高而确诊的钩端螺旋体病患者的临床和实验室数据。研究了患者从入院到出院期间全血细胞计数的变化。使用SPSS 13版（SPSS公司，芝加哥）进行数据分析。对收集的数据进行频率、百分比、均值、中位数、标准差和曼-惠特尼检验分析。p值小于0.05被认为具有统计学意义。
在轻症和重症疾病中，平均血红蛋白浓度从第1天到第7天均呈逐渐下降趋势（<12.5克/分升）。重症疾病患者的血小板计数显著降低（p = 0.002），（<150,000个细胞/立方毫米），与轻症疾病相比呈下降趋势。重症疾病患者在发病第4天至第5天的总白细胞计数显著升高（p = 0.001），（>11,000个细胞/立方毫米）。
全血细胞计数是监测钩端螺旋体病患者的常规检查。血红蛋白下降、明显血小板减少以及总白细胞计数正常至高值有助于早期发现重症疾病，从而通过及时治疗预防死亡。
