A study of sutopsy findings in 62 cases of leptospirosis in a metropolitan city in India.
BACKGROUND
Leptospirosis is an important sporadic zoonotic disease caused by the spirochete Leptospira icterohaemorrhagiae . The disease becomes a major public health problem, particularly during the monsoon months.


METHODS
Analysis of autopsy findings of 62 cases of clinically suspected leptospirosis was carried out to identify the pathology and determine the cause of death.


RESULTS
Most patients were young males who presented with fever, breathlessness, haemoptysis, bleeding, oliguria and icterus. They died after a brief stay in hospital. A post-mortem diagnosis of leptospirosis was made on the basis of characteristic organ findings, aided by results of serology, Levaditi's staining and / or immunohistochemistry (IHC) on kidney sections. Massive intra-alveolar haemorrhage (48 cases), acute interstitial nephritis and / or acute tubular necrosis (45 cases) and myocarditis (24 cases) were the main autopsy findings. Haemorrhage in various organs like the heart, gastrointestinal tract, brain, pancreas and adrenals were also seen. Thirty of 54 kidney sections were positive for leptospiral antigens by IHC. There was extensive haemorrhages in the lungs in 48 (77%) cases and that was the cause of death in most of these cases.


CONCLUSIONS
Bleeding into various tissues and organs is the main finding noted in this study. The post-mortem examination of patients dying of leptospirosis revealed that pulmonary haemorrhage was the cause of death in most individuals.
Salkade
H P
HP
Dept. of Pathology, Topiwala National Medical College and B. Y. L. Nair Ch. Hospital, Mumbai, India. hemapsalkade@hotmail.com
Divate
S
S
Deshpande
J R
JR
Kawishwar
V
V
Chaturvedi
R
R
Kandalkar
B M
BM
Vaideeswar
P
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D001344:Autopsy; D002423:Cause of Death; D002648:Child; D005260:Female; D006801:Humans; D007194:India; D007922:Leptospirosis / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014504:Urban Health