Clinical and laboratory findings in patients with leptospirosis at a tertiary teaching hospital in Jamaica

Abstract

Donovan McGrowder1, Paul Brown21Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica, West Indies; 2Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston, Jamaica, West IndiesBackground: Leptospirosis is a zoonotic disease that is endemic in most Caribbean countries. This study examined the clinical presentations and laboratory findings in serologically confirmed cases of leptospirosis.Patients and methods: The medical records of all hospitalized patients with presumptive and confirmed leptospirosis between June 2005 and May 2006 at the University Hospital of the West Indies were retrospectively reviewed.Results: There were five serologically confirmed cases of leptospirosis. The mean age of patients with leptospirosis was 57.33 ± 8.21 years (range 41–67 years); all were men exposed to contaminated water or soil, and most cases were diagnosed in November. The most common symptoms were fever, myalgia, nausea, vomiting, headache, abdominal pain, and arthralgia. Increase in the mean serum creatinine concentration in patients with leptospirosis (439.40 ± 129.18 µmol/L) was significant when compared with that in the controls (87.86 ± 4.72 µmol/L; P = 0.005). Four of the five patients with leptospirosis showed evidence of hematuria. All patients with leptospirosis showed evidence of hyperbilirubinemia, which was mostly direct hyperbilirubinemia. The mean concentration of total bilirubin was 291.40 ± 52.33 µmol/L in patients with leptospirosis when compared with 9.83 ± 1.28 µmol/L in controls (P < 0.001). Thrombocytopenia (platelet count <150,000 cells/mm3) was observed in 80% of the patients with leptospirosis.Conclusion: The study indicates the variable clinical manifestations of leptospirosis and emphasizes the importance of continued vigilance of physicians and primary health care workers in increasing the awareness of the seasonal distribution and the need for early diagnosis of leptospirosis.Keywords: leptospirosis, serological, clinical manifestations, Jamaica, laboratory findings