de Silva Nipun Lakshitha, Sivayoganathan Sriharan, Sivashangar Ahalya, Wickramasinghe Wasanthi, Gooneratne Lallindra, Rajapakse Senaka
Department of Clinical Medicine, Faculty of Medicine, General Sir John Kotelawala Defence University, Sri Lanka.
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka.
Trans R Soc Trop Med Hyg. 2018 Feb 1;112(2):94-96. doi: 10.1093/trstmh/try024.
Blood smear changes have never been investigated as a potential tool to aid in the diagnosis of leptospirosis.
Blood smears prepared from patients with leptospirosis, dengue and sepsis within the first 5 days of illness were reported by haematologists blinded to the diagnosis.
A total of 20, 28 and 22 patients with leptospirosis, dengue and sepsis, respectively, were analysed. Neutrophil leucocytosis, toxic changes in neutrophils, left shift, reactive lymphocytes, target cells and thrombocytopaenia were seen in 60%, 70%, 40%, 70%, 50% and 65% of the leptospirosis patients, respectively. The combination of reactive lymphocytes with toxic neutrophils or neutrophil leucocytosis was highly suggestive of leptospirosis.
Peripheral blood smear findings may be helpful in differentiating leptospirosis from other common acute febrile illnesses.
血液涂片变化从未被作为一种辅助诊断钩端螺旋体病的潜在工具进行研究。
由对诊断不知情的血液学家报告在发病后前5天内从钩端螺旋体病、登革热和脓毒症患者制备的血液涂片情况。
分别对20例、28例和22例钩端螺旋体病、登革热和脓毒症患者进行了分析。钩端螺旋体病患者中分别有60%、70%、40%、70%、50%和65%出现中性粒细胞增多、中性粒细胞毒性变化、核左移、反应性淋巴细胞、靶形细胞和血小板减少。反应性淋巴细胞与毒性中性粒细胞或中性粒细胞增多相结合高度提示钩端螺旋体病。
外周血涂片检查结果可能有助于鉴别钩端螺旋体病与其他常见急性发热性疾病。
