[Respiratory manifestations of leptospirosis. A retrospective study of 91 cases (1978-1984)].

Abstract

Leptospirosis, an ubiquitous zoonotic disease, is a systemic infection usually producing fever with hepatorenal involvement, meningoenephalitis, and hemorrhage. Respiratory manifestations are less well known but have been described in certain regions such as Southeast Asia or the Reunion Island. From January 1978 through December 1994, 154 cases of documented leptospirosis were admitted to the South Reunion Hospital Center. Pulmonary involvement was observed in 91 of these cases (59.1%) with hemoptysis (37.4%) and radiological evidence of bilateral reticulonodular infiltration (40%). Extra-pulmonary manifestations in most cases suggested leptospirosis at admission. Thirteen consecutive patients underwent endoscopy explorations with bronchoalveolar lavage: intra-alveolar hemorrhage was evidenced in all cases. This highly typical pattern of cytolysis would emphasize (20.8%) when the classical extra-pulmonary signs are too discrete to suggest the diagnosis. In this series, 10 patients required ventilatory assistance and 2 were given corticosteroid boluses for massive hemoptysis. Mortality due to leptospirosis is two-fold higher in cases with pulmonary involvement.

• Authors: J P Courtin, M Di Francia, I Du Couëdic, P Poubeau, C Mahé, J Bapteste, C Arvin-Berod
• Journal: Revue de pneumologie clinique (Rev Pneumol Clin) Vol. 54 Issue 6 Pg. 382-92 (Dec 1998) ISSN: 0761-8417 [Print] France
• Vernacular Title: Les manifestations respiratoires de la leptospirose. Etude rétrospective de 91 cas (1978-1994).
• PMID: 10100353 (Publication Type: Comparative Study, English Abstract, Journal Article, Review)

Chemical References

• Anti-Inflammatory Agents
• Penicillins
• gamma-Globulins
• Methylprednisolone

Topics

• Adolescent
• Adult
• Aged
• Anti-Inflammatory Agents (therapeutic use)
• Bronchoalveolar Lavage Fluid
• Bronchoscopy
• Chest Pain (etiology)
• Child
• Cough (etiology)
• Female
• Hematologic Tests
• Hemoptysis (etiology)
• Humans
• Leptospirosis (diagnosis, therapy)
• Male
• Methylprednisolone (therapeutic use)
• Middle Aged
• Penicillins (therapeutic use)
• Pneumonia, Bacterial (diagnosis, therapy)
• Radiography, Thoracic
• Respiration, Artificial
• Retrospective Studies
• Tomography, X-Ray Computed
• Weil Disease (complications)
• gamma-Globulins (therapeutic use)