Ananthi, B (2009) Correlation of Different Laboratory Parameters in the Diagnosis of Leptospirosis. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : India with long coastline, has one of the major important coastal agro ecosystem that supports livelihood of several million people. However this system is highly fragile. Due to the rapid ecological changes during the past decade many zoonotic diseases have emerged and resulted in epidemics leading to significant morbidity and mortality in humans. Leptospirosis is one among them. Leptospirosis is a zoonotic infection caused by the spirochaete of the Genus Leptospira. It affects humans worldwide, in both urban and rural areas and in temperate and tropical climates.46 Pathogenic leptospires live in the kidney of natural hosts, predominantly mammals and are excreted with the urine into the environment where they survive for several months in humid, warm and slightly alkaline conditions. Humans are accidental hosts and are infected by contact with an environment contaminated by urine of shedder hosts such as rodents, cattle and dogs. Hence this study was conducted with the objective of correlating different laboratory parameters including radiological features in leptospirosis so that a quick clinical suspicion can be made out and diagnosed early for initiating appropriate treatment and for a better outcome. AIMS AND OBJECTIVES : 1. To study and correlate the haematological, bio-chemical and radiological parameters in the diagnosis of leptospirosis. 2. To identify the predominant serovar in leptospirosis . 3. To study the concomitant infection of leptospirosis with Dengue and Hepatitis B. MATERIALS AND METHODS : This cross sectional study included 378 patients who attended Government General Hospital, Chennai with fever of 5 days and more duration and of the age group 11 years and above. Only patients with features suggestive of leptospirosis were included in this study. Patients with fever associated with malignancies, autoimmune diseases were excluded from this study. Demographic and clinical variables were given in frequencies with their percentages. Incidence were given in proportion with 95% confidence interval. Statistical difference were found using one sample chi-square test. p<0.05 were considered statistically significant. MATERIALS: 378 blood samples were collected from patients with clinical symptoms suggestive of leptospirosis during this study period. • From all these patients 2ml of blood was collected by venepuncture with aseptic precautions and the serum was subjected to serological test for leptospirosis – MSAT. • 156 sample out of this were positive for the serological test MSAT. • Detailed clinical history was obtained from all positive cases of leptospirosis. • Biochemical profile, haematological parameters and radiological parameters of the leptospirosis positive patients were studied. • 10 ml of blood was collected from these patients, serum separated and investigated for 1. Dengue IgM, antibody capture ELISA, 2. Rapid test - Dengue Duo cassette, 3. HBs Ag capture ELISA, 4. Rapid test – One step Cassette Style HBsAg Test. RESULTS : Total No of samples taken : 378 ; Total No of MSAT positive samples : 156 ; Total No of samples included in the study : 156. 41.26% of patients were positive by MSAT. 95% Confidence Interval is 36% - 46%. The incidence was relatively higher in 21-30 age groups. There was almost equal incidence of leptospirosis in males and females with very slight preponderance in males. One Sample Chi-square test x²=0.10,p=0.75. Incidence of leptospirosis was seen throughout the year, although the number of cases increased after rainy season. Jaundice was found to be the predominant sign. 143 samples(91.66%) were positive for MAT 95% Confidence Interval is 86.51% - 95.3%. ESR raised in all cases (100%), followed by abnormal LFT in 71.79% of patients. CONCLUSION : In conclusion, by correlating the biochemical and haematological parameters a quick clinical suspicion of leptospirosis can be made out and diagnosed early, for initiating appropriate treatment. The predominant serovar was L.icterrohaemorrhagiae (49.65%). Concomitant infection of leptospirosis with dengue and hepatitis B were seen and leptospirosis should not be missed in such scenario since antimicrobial agents for leptospirosis can reduce its severity and duration. There was no mortality observed in this study due to early recognition and intensive treatment, even in the severe form of disease. Early recognition and appropriate treatment leads to a favourable outcome of this potentially life threatening condition.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Correlation ; Different Laboratory Parameters ; Diagnosis ; Leptospirosis. |
| Subjects: | MEDICAL > Microbiology |
| Depositing User: | Subramani R |
| Date Deposited: | 14 Aug 2017 18:08 |
| Last Modified: | 14 Aug 2017 18:08 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1768 |
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