JOURNAL OF EVIDENCE BASED MEDICINE AND HEALTHCARE

Table of Contents

2018 Month : August Volume : 5 Issue : 33 Page : 2439-2444

COMPLETE BLOOD COUNT, IgM AND URINE ROUTINE IN LEPTOSPIROSIS AND THEIR ASSOCIATION WITH SEVERITY IN AN ENDEMIC AREA

Elizabeth Jacob1, Sinu R. V2

Corresponding Author:
Dr. Sinu R. V,
Assistant Surgeon,
Primary Health Centre,
Amachal, Trivandrum, Kerala.
E-mail: sinu.r.v@gmail.com
DOI: 10.18410/jebmh/2018/503

BACKGROUND
Leptospirosis is an important cause of mortality and morbidity in India. The present study is conducted to evaluate the association of various blood parameters and urinary parameters with the severity of leptospirosis.

MATERIALS AND METHODS
Our descriptive study enrolled 84 participants with leptospirosis aged 18 years or above admitted under General Medicine in a period of 2 years. Participants with pre-existing renal, hepatic and respiratory diseases were excluded. Study was approved by Institutional Ethics Committee and written informed consent was obtained from all study participants. All investigations were done in the central laboratory of the institution and results were analysed using R®. Parameters are expressed as categorical variables and association was determined using Chi-square test and Fischer’s exact test and p <0.05 was considered statistically significant.

RESULTS
Among the study participants, 71% were males and 70% had severe leptospirosis. 72% participants had normal leukocyte count, 70% participants had neutrophilia and 32% participants had lymphocytosis. 66% had thrombocytopenia and 2.4% participants had platelet count less than 10,000 cells/μL. 89% participants had elevated erythrocyte sedimentation rate (ESR). 23.8% participants had more than 5 pus cells in urine and 69% had granular cast in urine. Significant association was observed with severity of leptospirosis for platelet count (p<0.001), ESR (p=0.01; OR: 5.9, 95% CI: 1.3–25.9), pyuria (p=0.03; OR: 5, 95% CI 1.1–23.7) and granular cast in urine (p<0.001; OR: 0.6, 95% CI 0.4-0.7).

CONCLUSION
Early diagnosis, monitoring of clinical and laboratory parameters and prompt intervention in terms supportive care and antibiotic therapy will help in reducing morbidity and mortality.

KEYWORDS
Leptospirosis, Platelet Count, Erythrocyte Sedimentation Rate, Urine Pus Cells, Granular Cast in Urine.