Radiographic chest findings and clinical correlations in leptospirosis.
OBJECTIVE
To determine the clinical presentations, radiographic chest findings, and their correlation in patients with leptospirosis.


METHODS
A cross sectional study.


METHODS
Between July 2001- December 2002 at 3 hospitals in North Eastern Thailand.


METHODS
Two hundred and forty patients with laboratory confirmed leptospirosis.


RESULTS
Two hundred and nine (87.1%) patients were males. The mean age was 37.53 years (range 13-76). The median duration of fever was 3 days (range 1-13). Overall, 154 patients (64.2%) had respiratory symptoms and 26 (10.8%) patients had hemoptysis. Jaundice was detected in 76 (31.7%) patients, hypotension in 50 (20.8%), renal dysfunction in 80 (30%), and multiorgan dysfunction in 62 (25.8%) on admission. One hundred and fifty-four (64.17%) patients had abnormal chest radiographs on admission (classified as cardiovascular, pulmonary, and mixed cardio-pulmonary involvement in 40 (25.97%), 41 (26.62%), and 73 (47.4%) patients, respectively). Jaundice was significantly associated with the likelihood of having abnormal chest radiography on admission. Air- space nodules detected on the chest radiograph were significantly more common in patients with renal dysfunction and patients who required mechanical ventilation.


CONCLUSIONS
Pulmonary and cardiovascular involvements are common in leptospirosis. Air-space nodules detected by chest radiography may indicate severe leptospirosis.
Chawalparit
Orasa
O
Department of Radiology, Faculty of Medicine at Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand. oak@yahoo.com
Charoensak
Apinya
A
Niwattayakul
Kanigar
K
Suttinont
Chuanpit
C
Losuwanaluk
Kitti
K
Silpasakorn
Saowaluk
S
Suputtamongkol
Yupin
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007922:Leptospirosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013902:Radiography, Thoracic; D013785:Thailand; D013909:Thorax / Q000473:pathology*