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PubMed2005

[Longitudinal epidemiology of leptospirosis in the Czech Republic (1963-2003)].

After higher rates of occupational or leisure diseases recorded in the Czech Republic in the second half of the last century it was found that the last climatic changes and catastrophic floods of 1997 and 2002 were followed by outbreaks of leptospirosis as the only re-emerging postflood infection. While in tropics and subtropics the monsoon season is typically followed by highly increased rates of leptospirosis in humans, even, with fatal outcomes, this phenomenon remained unknown under the climatic conditions of the Czech Republic where human leptospirosis has been reported rather sporadically, mostly in natural foci of infection, and its incidence rate is usually about 0.3% per 100,000 population. Nevertheless, after the unexpected vast floods of 1997 and 2002 that also afflicted natural foci of leptospirosis, the rates of reported and serologically confirmed cases of leptospirosis in the Czech Republic were three times as high as usual with the specific morbidity reaching 0.9 case per 100,000 population. In 1997, as many as 7156 persons were tested for leptospirosis in the Czech Republic: the disease was diagnosed and reported in 94 patients and in 2002, 92 out of 4999 persons tested were diagnosed with leptospirosis. Two thirds of these cases were from inundation areas, half of them being directly associated with floods (exposure to residual water, flood mud in cellars, etc.). Four case of Weil disease reported in 1997 were fatal. As many as 41 deaths from Weil disease have been reported in the Czech Republic since 1963 when the disease became reportable.

Czech Republic↗
PubMed2002

[Weil's disease: a case report of acquired leptospirosis in Switzerland].

Leptospirosis is a rare disease in Switzerland. However its incidence is probably underestimated, due to its broad spectrum of presentations, including subclinical benign forms and the ictero-hemorragic form of the Weil's syndrome, whose mortality is high. We describe here a case of Weil's syndrome acquired in Switzerland with a favourable outcome under antibiotherapy. Even in the absence of any travel, the association of an acute renal insufficiency and jaundice with only moderate hepatic cytolysis should lead to the suspicion of leptospirosis. Clinical and epidemiological aspects of the disease are discussed in the article.

Aged↗
PubMed2002

Leptospirosis in children in Mumbai slums.

OBJECTIVE: There is limited data available on symptomatic leptospirosis in Indian children. We report an outbreak of leptospirosis that occurred in children living in slums following heavy rainfall and flooding. This hospital-based prospective study was conducted from July to August 2001. METHODS: Diagnosis of acute leptospirosis was suspected by following the Indian Leptospirosis Society working definition for leptospirosis. Diagnosis was confirmed by detecting anti-Leptospira antibodies, using either a Leptospira genus-specific latex agglutination assay or a dipstick assay or by a macroscopic slide agglutination test. RESULT: Thirty (32%) out of 93 children admitted had acute leptospirosis. Fever, bodyache, chills, abdominal pain, headache, vomiting, cough, hepatosplenomegaly, edema and crepitations were the common presenting signs and symptoms. Twenty - two children had anicteric leptospirosis and 8 had Weil disease. Response to penicillin treatment was good in all except in one child with Weil disease who died of renal failure within 3 hours of admission. CONCLUSION: Leptospirosis has emerged as an infectious disease in Mumbai. During monsoon, parents should ensure that their child does not have contact with the contaminated flood water.

Child↗
PubMed2000

[Ceftazidime in the treatment of Weil's disease]

We present a case report of leptospirosis with acute renal failure and hepatic dysfunction. Aspecific clinical presentation and serologic tests do not help therapeutic choices. The patient received 18 sessions of hemodialysis and early treatment with intravenous ceftazidime 1 g tid (under the impression of Gram- sepsis). Third generation cephalosporins, ceftriaxone and cefotaxime, are highly active against Leptospira [10] while clinical experience with ceftazidime is lacking.

Journal Article↗
PubMed1988

[Weil-Vasil'ev disease in the Burgas region].

31 patients with Weil-Vassilev's disease are discussed epidemiologically, clinically and by laboratory indices. The disease is predominantly professional, the minors prevailing. Clinically it is manifested by acute onset, febrile and toxiinfectious syndrome and various organ manifestations--liver, renal, meningeal. The hepato-renal syndrome is leading (64.5%). The patient's fate is determined by the renal failure mainly. Hemodialysis and proper intensive care play a decisive role in the treatment. Since the patients are admitted to hospital late, on the sixth day mean, the antibiotic treatment is of less importance. The disease is not well known by the physicians and the initial diagnosis is usually wrong.

Adult↗
PubMed1989

[Multiple organ failure syndrome in infection caused by ictero-hemorragic Leptospira. Description of a clinical case].

A 53 years old fisherman was admitted to General Intensive Care Unit in Arezzo with signs and symptoms of Weil disease. An early acute respiratory failure developed. Radiological and haemodynamic findings confirmed a diagnosis of ARDS. The patient developed a severe jaundice, acute renal failure and ARDS (MOF multiple organs failure). To support different failures of the organs, CMV (continuous mandatory ventilation: CPPV with PEEP max 10 cm H2; IRV max 2:1) and AMV (assisted mandatory ventilation: Pressure Support Ventilation), haemofiltration, haemoperfusion and plasmapheresis were simultaneously used, that got better and better renal and respiratory performances. Haemodynamic worsening by PEEP during extracorporeal treatment was overcome by PSV very useful new ventilatory procedure even during weaning period. The patient treated in such manner survived without important disabilities. This care confirms that ARDS (non cardiogenic edema) and MOF can develop during Icterohaemorrhagic Leptospirosis.

Acute Kidney Injury↗