Severe Leptospirosis - A case series and review
By: BWP Habaragamuwa and Gihan Piyasiri
Open Access
|Mar 2011Abstract
Background The purpose of this retrospective case review was to identify different patterns of clinical presentation of severe leptospirosis, and to find out any correlation between organ specific complication/s and outcome of the patients.
Method Leptospirosis patients who were admitted to the intensive care unit (ICU) at the Colombo South Teaching Hospital during August to September 2008 were included. Organ specific involvement in six organs (heart, lung, kidney, liver, vascular, brain and spinal cord) was recorded. One score was given to each organ involvement. Score was recorded on admission and during ICU stay. Outcome of the patient was recorded as either discharged or died in the ICU.
Results Renal, hepatic and haematological involvement was found in all patients. 13(65%) patients died and 7(35%) patients were discharged to the ward. All patients with four organ involvement were survived. All patients with six organ involvement died in the intensive care unit. 8(80%) patients died and 3(20%) patients survived among patients with five organ involvement. Four or more organs were affected on admission to ICU in patients who died and only three organs were affected in discharged patients.
Conclusion Outcome of severe leptospirosis was not determined by the involvement of renal, hepatic and haematological systems. Five or more organ involvement was associated with increased mortality. Combination of cardiac and respiratory system involvement or involvement of central nervous system was associated with bad outcome. Seeking critical care management at three organ involvement stage would improve the outcome of the patients.
Key words: organ; score; system
DOI: 10.4038/slja.v19i1.2866
Sri Lankan Journal of Anaesthesiology Vol.19(1) 2011 pp.22-25
Method Leptospirosis patients who were admitted to the intensive care unit (ICU) at the Colombo South Teaching Hospital during August to September 2008 were included. Organ specific involvement in six organs (heart, lung, kidney, liver, vascular, brain and spinal cord) was recorded. One score was given to each organ involvement. Score was recorded on admission and during ICU stay. Outcome of the patient was recorded as either discharged or died in the ICU.
Results Renal, hepatic and haematological involvement was found in all patients. 13(65%) patients died and 7(35%) patients were discharged to the ward. All patients with four organ involvement were survived. All patients with six organ involvement died in the intensive care unit. 8(80%) patients died and 3(20%) patients survived among patients with five organ involvement. Four or more organs were affected on admission to ICU in patients who died and only three organs were affected in discharged patients.
Conclusion Outcome of severe leptospirosis was not determined by the involvement of renal, hepatic and haematological systems. Five or more organ involvement was associated with increased mortality. Combination of cardiac and respiratory system involvement or involvement of central nervous system was associated with bad outcome. Seeking critical care management at three organ involvement stage would improve the outcome of the patients.
Key words: organ; score; system
DOI: 10.4038/slja.v19i1.2866
Sri Lankan Journal of Anaesthesiology Vol.19(1) 2011 pp.22-25
DOI: https://doi.org/10.4038/slja.v19i1.2866 | Journal eISSN: 2279-1965
Language: English
Page range: 22 - 25
Published on: Mar 14, 2011
Published by: College of Anaesthesiologists of Sri Lanka
In partnership with: Paradigm Publishing Services
© 2011 BWP Habaragamuwa, Gihan Piyasiri, published by College of Anaesthesiologists of Sri Lanka
This work is licensed under the Creative Commons License.