Leptospirosis in Tropical Regions of Southeast Mexico: A Clinical Case Series Review
Por:
Svarch A.E., Arce-Salinas C.A., Amaya J.L., Garcia M.N.
Publicada:
1 ene 2017
Resumen:
Purpose of Review: Leptospirosis is a worldwide zoonosis associated with high rates of morbidity and mortality. Its clinical expression is variable and can be particularly challenging to diagnose. Despite evidence of its transmission in Mexico, very little has been reported regarding human cases. The objective of our review was to describe the clinical manifestations of Leptospira strains present in Southeastern Mexico, and identify distinguishing characteristics from other endemic regions. Recent Findings: We performed a review of state-reported cases from two large hospitals in Southeastern Mexico, an area suspected to have the highest incidence of the infection. Of 98 state-reported probable cases of leptospirosis, a total of 19 cases were confirmed serologically and further described here in an effort to highlight examples of reported cases to increased physician awareness. Patients had an average age of 40 years old, and were mostly female. World Health Organization-based classification according to the clinical expression, showed 12 cases with flu-like disease, 3 Weil’s syndrome, 3 with pulmonary hemorrhage/failure, and 1 with meningitis/meningoencephalitis. The average length of stay in hospital since the onset of symptoms to diagnosis varied according to the clinical presentation: 2.5 days for the flu-like syndrome, 3.3 days for Weil’s, 4 days for CNS involvement, and 16.5 days for pulmonary disease. Regardless of the category, renal and hepatic involvement was very frequent, even in patients with mild disease. Summary: Leptospirosis in Southeastern Mexico is likely underreported, with the true disease burden being largely unknown. In this population, the most common presentation was a mild disease with good response to antibiotics. Patients with more severe disease had greater delay in diagnosis and negative outcomes. Understanding all possible expressions of Leptospira infections by health personnel is essential for improved decision-making. © 2017, Springer International Publishing AG.
Filiaciones:
Svarch A.E.:
Department of Internal Medicine, Hospital Central Sur de Petróleos Mexicanos, Mexico City, Mexico
Arce-Salinas C.A.:
Department of Internal Medicine, Hospital Central Sur de Petróleos Mexicanos, Mexico City, Mexico
Amaya J.L.:
Department of Internal Medicine, Hospital Central Sur de Petróleos Mexicanos, Mexico City, Mexico
Garcia M.N.:
Department of Pediatric Tropical Medicine, National School of Tropical Medicine, Baylor College of Medicine, Houston, TX, United States
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