Sreejith R, Thulasidharan N. K
BACKGROUND Leptospirosis is one of the most common zoonotic diseases prevalent in the world and very common in India. It is caused by the spirochaete Leptospira spp. It is endemic in Kerala with frequent epidemics during rainy seasons. Severe leptospirosis or the Weil’s syndrome is characterized by fever with myalgia, icterus, acute kidney injury, thrombocytopenia with high mortality. Other organs like heart, pancreas and lungs are involved rarely. This study was conducted to assess the clinical profile and to detect the trends in clinical presentation and complications of Leptospirosis. MATERIALS AND METHODS This was a retrospective study conducted at Government Medical College, Kozhikode, a tertiary care centre in North Kerala, India, involving 150 cases of IgM ELISA positive cases of Leptospirosis from inpatients of medical wards and ICU. All the patients were investigated and assessed for the complications and outcome. RESULTS 150 clinically and serologically confirmed cases of leptospirosis were included in this study of which 109 (72.7%) were males and 103 (68.7%) were manual labourers. Of the 150 cases, 22 (14.7%) patients expired. Fever was present in all patients with myalgia being the most common associated symptom followed by headache and vomiting. Most common sign was conjunctival congestion (127, 84%) followed by calf muscle tenderness (95, 63.3%). Most common complication encountered was hepatorenal syndrome (103, 68.7%). There was a high incidence of myocarditis (43, 28.7%), ARDS (27, 18%) and pancreatitis (26, 17.3%). CONCLUSION Leptospirosis is very common in Kerala and occurs throughout the year with an increasing incidence from the months of August to October. Manual labourers, especially males were the most common group affected. Most common complication encountered was hepatorenal syndrome with relatively early onset i.e. by the end of first week. There was a relatively increased incidence of complications like myocarditis, ARDS and pancreatitis in our study suggesting an increased incidence of sepsis like presentation with MODS.
