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Profile of patients of leptospirosis in sub-Himalayan region of North India.
J Assoc Physicians India. 2010 Jun; 58:354-6.JA

Abstract

CONTEXT

Leptospirosis is an emerging zoonosis world wide; it is being reported in many areas of south-east Asia now. A recent surge in the number of patients with leptospirosis has been noted in the Sub-Himalayan region of North India which was uncommon. We present here a case series of 13 patients who were positive for leptospirosis either by IgM Elisa or PCR method.

AIMS

To study the profile of leptospirosis in a sub-Himalayan state of North India i.e. Himachal Pradesh.

SETTINGS AND DESIGN

This was a retrospective study of leptospira positive patients who were admitted in IGMC, Shimla. The study was conducted in Indira Gandhi Medical College, Shimla situated at a moderate altitude in North India.

METHODS AND MATERIAL

All patients presenting in Medical College Hospital during three months from 1st August to 31st October who tested IgM positive or borderline or PCR positive for leptospirosis were taken into the study. Their presenting complaints, examination findings and lab findings were recorded and analyzed based on the Faine's criteria and modified Faine's criteria. Patients with clinical features of Leptospirosis and who tested positive for IgM Leptospirosis were taken as IgM lepto can be falsely positive.

RESULTS

Out of total 13 patients there were 3 males and 10 females, age range was from 24 to 78 yrs and mean was 44 yrs. Predominant complaints were fever, jaundice, myalgia, and headache. All had contact with animals or contaminated environment. LFT's were deranged in 12 and renal functions were deranged in all. Ten had positive results for IgM against leptospira while 2 had borderline positive result. One patient was positive by PCR method using G1, G2 primers. Ten patients had Weil's syndrome and this was the main presentation of leptospirosis in our group, one had acute respiratory distress syndrome (ARDS) and needed ventilator. There were no deaths. All responded to injectable ceftriaxone and oral doxycycline. Applying Faine's criteria only 7 were positive, but using modified Faine's criteria all 13 were positive for leptospirosis.

CONCLUSIONS

Leptospirosis was unexpectedly found to be positive in many of our patients who were having pyrexia during the monsoons. A recent surge has been noted in the number of cases with leptospirosis in this state. The possibility of co-infection especially with scrub typhus must be considered in cases with atypical presentation and severe illness. Most of the patients were from rural background with poor hygienic conditions. There was no mortality and main complication was Weil's syndrome in 77 percent.

Authors+Show Affiliations

Department of Medicine, Dr.Rajendra Prasad Government Medical College, Tanda.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21125775

Citation

Chauhan, V, et al. "Profile of Patients of Leptospirosis in sub-Himalayan Region of North India." The Journal of the Association of Physicians of India, vol. 58, 2010, pp. 354-6.
Chauhan V, Mahesh DM, Panda P, et al. Profile of patients of leptospirosis in sub-Himalayan region of North India. J Assoc Physicians India. 2010;58:354-6.
Chauhan, V., Mahesh, D. M., Panda, P., Mokta, J., & Thakur, S. (2010). Profile of patients of leptospirosis in sub-Himalayan region of North India. The Journal of the Association of Physicians of India, 58, 354-6.
Chauhan V, et al. Profile of Patients of Leptospirosis in sub-Himalayan Region of North India. J Assoc Physicians India. 2010;58:354-6. PubMed PMID: 21125775.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Profile of patients of leptospirosis in sub-Himalayan region of North India. AU - Chauhan,V, AU - Mahesh,D M, AU - Panda,P, AU - Mokta,J, AU - Thakur,S, PY - 2010/12/4/entrez PY - 2010/12/4/pubmed PY - 2010/12/17/medline SP - 354 EP - 6 JF - The Journal of the Association of Physicians of India JO - J Assoc Physicians India VL - 58 N2 - CONTEXT: Leptospirosis is an emerging zoonosis world wide; it is being reported in many areas of south-east Asia now. A recent surge in the number of patients with leptospirosis has been noted in the Sub-Himalayan region of North India which was uncommon. We present here a case series of 13 patients who were positive for leptospirosis either by IgM Elisa or PCR method. AIMS: To study the profile of leptospirosis in a sub-Himalayan state of North India i.e. Himachal Pradesh. SETTINGS AND DESIGN: This was a retrospective study of leptospira positive patients who were admitted in IGMC, Shimla. The study was conducted in Indira Gandhi Medical College, Shimla situated at a moderate altitude in North India. METHODS AND MATERIAL: All patients presenting in Medical College Hospital during three months from 1st August to 31st October who tested IgM positive or borderline or PCR positive for leptospirosis were taken into the study. Their presenting complaints, examination findings and lab findings were recorded and analyzed based on the Faine's criteria and modified Faine's criteria. Patients with clinical features of Leptospirosis and who tested positive for IgM Leptospirosis were taken as IgM lepto can be falsely positive. RESULTS: Out of total 13 patients there were 3 males and 10 females, age range was from 24 to 78 yrs and mean was 44 yrs. Predominant complaints were fever, jaundice, myalgia, and headache. All had contact with animals or contaminated environment. LFT's were deranged in 12 and renal functions were deranged in all. Ten had positive results for IgM against leptospira while 2 had borderline positive result. One patient was positive by PCR method using G1, G2 primers. Ten patients had Weil's syndrome and this was the main presentation of leptospirosis in our group, one had acute respiratory distress syndrome (ARDS) and needed ventilator. There were no deaths. All responded to injectable ceftriaxone and oral doxycycline. Applying Faine's criteria only 7 were positive, but using modified Faine's criteria all 13 were positive for leptospirosis. CONCLUSIONS: Leptospirosis was unexpectedly found to be positive in many of our patients who were having pyrexia during the monsoons. A recent surge has been noted in the number of cases with leptospirosis in this state. The possibility of co-infection especially with scrub typhus must be considered in cases with atypical presentation and severe illness. Most of the patients were from rural background with poor hygienic conditions. There was no mortality and main complication was Weil's syndrome in 77 percent. SN - 0004-5772 UR - https://www.unboundmedicine.com/medline/citation/21125775/Profile_of_patients_of_leptospirosis_in_sub_Himalayan_region_of_North_India_ L2 - http://www.diseaseinfosearch.org/result/4178 DB - PRIME DP - Unbound Medicine ER -