title: [Community acquired pneumonia and pulmonary hemorrhage in leptospirosis in the Buenos Aires metropolitan area].
abstract: The aim of this paper is to report the epidemiological, clinical and diagnosis findings of pneumonia and pulmonary hemorrhage observed in patients with leptospirosis in the period January 2007 to October 2009. A 64% (20/31) of patients diagnosed with leptospirosis presented pneumonia. Fifteen of them (75%) had severe pneumonia, of which seven (35%) were pulmonary hemorrhage. In ten patients (32%) reason for consultation and clinical early stage was a secretory gastroenteritis with fever and abdominal pain. Jaundice was only expressed in eleven patients (35%). The technique of chain reaction (PCR) was useful for diagnosis in samples obtained post mortem. A strain classified in serogroup canicola was isolated from blood culture. Pneumonia was classified into three types: non-severe pneumonia course with little overall impact; severe pneumonia associated with systemic clinical forms with jaundice, renal failure, thrombocytopenia, and pulmonary hemorrhage, and of serious course, not associated with jaundice, kidney failure or thrombocytopenia. Antibiotic treatment started in the early stages of disease (average 3.2 days) had no influence on the development of severe pneumonia. It is puggested to consider three clinical forms of leptospirosis: anicteric, icteric (with its evolutionary variants) and pulmonary hemorrhage.
authors.affiliation: Hospital de Enfermedades Infecciosas Francisco J. Muñiz, Buenos Aires, Argentina. ceijo@intramed.net
authors.forename: Alfredo
authors.initials: A
authors.lastname: Seijo
authors.forename: Yamila
authors.initials: Y
authors.lastname: Romer
authors.forename: Jorge
authors.initials: J
authors.lastname: San Juan
authors.forename: Raúl
authors.initials: R
authors.lastname: Prieto
authors.forename: Mabel
authors.initials: M
authors.lastname: Nogueras
authors.forename: Lautaro
authors.initials: L
authors.lastname: De Vedia
authors.forename: Luis
authors.initials: L
authors.lastname: Font Nine
authors.forename: Sergio
authors.initials: S
authors.lastname: Giamperetti
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina / Q000453:epidemiology; D002648:Child; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D007922:Leptospirosis / Q000150:complications* / Q000453:epidemiology; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000209:etiology*; D016133:Polymerase Chain Reaction; D012720:Severity of Illness Index; D055815:Young Adult