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  1. Leptospira brings fresh challenge to adventure sports
    Trubo R
    Lancet Infect Dis, 2001 Sep;1(2):73.
    PMID: 11871475
    Matched MeSH terms: Leptospirosis/physiopathology
  2. Clinical presentations and predictors of mortality for leptospirosis - A study from suburban area in Malaysia
    Fann RJ, Vidya RR, Chong HE, Indralingam V, Christopher Chan WS
    Med J Malaysia, 2020 01;75(1):52-56.
    PMID: 32008021
    INTRODUCTION: Malaysia is endemic for leptospirosis with increasing incidence recorded over the years. Perak has recorded one of the highest incidence and mortality of leptospirosis since 2004.

    METHODS: This is a retrospective study of confirmed leptospirosis cases in Larut, Matang and Selama (LMS) district in Perak reported in 2016. The demographic, clinical presentation, laboratory result and clinical outcomes data were analysed and presented.

    RESULTS: Forty-two patients with confirmed diagnosis of leptospirosis were included into the study. Majority of patients were males and Malays. The case fatality rate was 14.3%. Patients with leptospirosis present with variable clinical presentations and are commonly seen with coinfection. Patients 70-year-old and older, have clinical presentations suggestive of organ dysfunction and require intensive care are associated with higher mortality.

    CONCLUSION: Leptospirosis is endemic in LMS district of Perak with high incidence and case fatality rate. The clinical presentation of leptospirosis is variable. Co-infection of leptospirosis with other acute febrile illness is common. Patients presenting with symptoms and signs of organ dysfunctions or require intensive care are associated with an increased odds of death.

    Matched MeSH terms: Leptospirosis/physiopathology*
  3. Raised levels of Il-6, Il-17a, and Il-22 in fatal leptospirosis
    Wan Yusoff WSY, Abdullah M, Sekawi Z, Amran F, Yuhana MY, Mohd Taib N, et al.
    Eur J Clin Microbiol Infect Dis, 2019 Dec;38(12):2349-2353.
    PMID: 31529307 DOI: 10.1007/s10096-019-03699-5
    Clinical manifestations of leptospirosis range from mild, common cold-like illness, to a life-threatening condition. The host immune response has been hypothesized to play a major role in leptospirosis outcome. Increased levels of inflammatory mediators, such as cytokines, may promote tissue damage that lead to increased disease severity. The question is whether cytokines levels may predict the outcome of leptospirosis and guide patient management. This study aimed to assess the association between Th1-, Th2-, and Th17-related cytokines with the clinical outcome of patients with leptospirosis. Different cytokine levels were measured in fifty-two plasma samples of hospitalized patients diagnosed with leptospirosis in Malaysia (January 2016-December 2017). Patients were divided into two separate categories: survived (n = 40) and fatal outcome (n = 12). Nineteen plasma samples from healthy individuals were obtained as controls. Cytokine quantification was performed using Simple Plex™ assays from ProteinSimple (San Jose, CA, USA). Measurements were done in triplicate and statistical analysis was performed using GraphPad software and SPSS v20. IL-6 (p = 0.033), IL-17A (p = 0.022), and IL-22 (p = 0.046) were significantly elevated in fatal cases. IL-17A concentration (OR 1.115; 95% CI 1.010-1.231) appeared to be an independent predictor of fatality of leptospirosis. Significantly higher levels of TNF-α (p ≤ 0.0001), IL-6 (p ≤ 0.0001), IL-10 (p ≤ 0.0001), IL-12 (p ≤ 0.0001), IL17A (p ≤ 0.0001), and IL-18 (p ≤ 0.0001) were observed among leptospirosis patients in comparison with healthy controls. Our study shows that certain cytokine levels may serve as possible prognostic biomarkers in leptospirosis patients.
    Matched MeSH terms: Leptospirosis/physiopathology
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