Leptospirosis and its pulmonary complications.
OBJECTIVE
The aim of this study was to assess the incidence and factors associated with pulmonary complications of leptospirosis.


METHODS
In a retrospective study, patients with a definite diagnosis of leptospirosis following a 6-week period of severe flooding in Hadyai city, Thailand, were reviewed. Pulmonary complications of leptospirosis were defined as the occurrence of respiratory symptoms and an abnormal CXR. The clinical and laboratory test results for patients with and without pulmonary complications were compared.


RESULTS
Among the 157 patients with leptospirosis, eight patients had pulmonary complications. Three patients had acute renal failure (ARF) and pulmonary oedema. One patient had ARF and adult respiratory distress syndrome (ARDS). Two patients had ARF, congestive heart failure and pulmonary oedema. One patient had congestive heart failure and pulmonary oedema. One patient had only ARF. Factors associated with pulmonary complications were delayed antibiotic treatment and thrombocytopenia (platelet count < 100 x 10(9)/L). Three patients developed adult respiratory distress syndrome and one died from respiratory failure.


CONCLUSIONS
Pulmonary complications and death occur in a low percentage of patients with leptospirosis. Delayed antibiotic treatment and thrombocytopenia are risk factors for the development of pulmonary involvement in leptospirosis.
Thammakumpee
Kreetha
K
Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand. tkreetha@medicine.psu.ac.th
Silpapojakul
Khachornsakdi
K
Borrirak
Baralee
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007922:Leptospirosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012131:Respiratory Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013785:Thailand / Q000453:epidemiology