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Clinical Investigations

Severe Leptospirosis - A case series and review

Authors:

BWP Habaragamuwa ,

Senior Registrar Anaesthesia and Critical Care, Colombo South Teaching Hospital, Kalubowila, LK
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Gihan Piyasiri

Registrar Anaesthesia, Colombo South Teaching Hospital, Kalubowila, LK
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Abstract

Background The purpose of this retrospective case review was to identify different patterns of clinical presentation of severe leptospirosis, and to find out any correlation between organ specific complication/s and outcome of the patients.

Method Leptospirosis patients who were admitted to the intensive care unit (ICU) at the Colombo South Teaching Hospital during August to September 2008 were included. Organ specific involvement in six organs (heart, lung, kidney, liver, vascular, brain and spinal cord) was recorded. One score was given to each organ involvement. Score was recorded on admission and during ICU stay. Outcome of the patient was recorded as either discharged or died in the ICU.

Results Renal, hepatic and haematological involvement was found in all patients. 13(65%) patients died and 7(35%) patients were discharged to the ward. All patients with four organ involvement were survived. All patients with six organ involvement died in the intensive care unit. 8(80%) patients died and 3(20%) patients survived among patients with five organ involvement. Four or more organs were affected on admission to ICU in patients who died and only three organs were affected in discharged patients.

Conclusion Outcome of severe leptospirosis was not determined by the involvement of renal, hepatic and haematological systems. Five or more organ involvement was associated with increased mortality. Combination of cardiac and respiratory system involvement or involvement of central nervous system was associated with bad outcome. Seeking critical care management at three organ involvement stage would improve the outcome of the patients.

Key words: organ; score; system

DOI: 10.4038/slja.v19i1.2866

Sri Lankan Journal of Anaesthesiology Vol.19(1) 2011 pp.22-25

Keywords: organ score system 
How to Cite: Habaragamuwa, B. & Piyasiri, G., (2011). Severe Leptospirosis - A case series and review. Sri Lankan Journal of Anaesthesiology. 19(1), pp.22–25. DOI: http://doi.org/10.4038/slja.v19i1.2866
Published on 14 Mar 2011.
Peer Reviewed

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