Leptospirosis in Himachal

8/14/2019 Leptospirosis in Himachal

1/9

Febrile Jaundice:

Leptospirosis

CPC by Unit III Medicine

IGMC


2/9

Leptospirosis is an emerging zoonosis

world wide

Being reported in many areas of South-East Asia now.

Till now not reported from Sub-Himalayan

region of North India.

We present the profile of 13 Leptospira

Positive patients (IgM Elisa or PCR).


3/9

All patients presenting in Indira Gandhi

Medical College during three months from

1st August to 31st October,2008 who

positive for leptospirosis were included.

Their presenting complaints, examination

findings, and lab findings were recorded

and analyzed based on the Faines criteriaand modified Faines criteria.


4/9

Following were noted

Presenting complaints, Age, Sex, Address,

Duration of pyrexia, Degree of temperature rise, Conjunctival suffusion, Headache,

Meningisms, Myalgias, Jaundice, Contact with animals or flood water, Titre of IgM for leptospira.


5/9

442925++294++-++10Savitri

40/F

13

412680+-57+++-+8Sundla

69/F

12

352118++28++--+5Anupama

40/F

11

252516++241++-+-8Savitri

42/F

10

352022+-86++---6Ramesh

35/M

9

382323++134+--++9Keshav

24/M

8

352056+-144+-+--7Jodhi Ram

78/M

7

422745++80+++-+10Leela Devi52/F

6

564180++175+++++10Babli

35/F

5

533826+-205++++-10SainKali

56/F

4

372224+-60+-+-+6Parwati

35/F

3

382332++99-+-+-7Rajni

32/F

2

564127++140+++++4Meera

42/F

1

Faines

Criteria

Score

Modified

Faines

Criteria

Score

WHO

IgM

Titre

(15)

Contact

With

animals

(10)

Jaundice

(1)

Urea

proteinuria

mg%

(2)

Head

ache

(2)

Muscle

Pain

(4)

Meningism

(4)

Conj

Suffusion

(4)

Temp

>39*

(2)

Duration

Of

pyrexia

Days (2)

NameNo


6/9

Total number of patients 13. 3 males &10 females. The age range 24 to 78 yrs

Mean age 44 yrs. All had history of contact with animals (cattle or

rodents) 12 had deranged renal functions,

12 had headache, 10 had muscle pain, 9 were in second week of pyrexia Mean duration

of pyrexia 7.5 days 7 had jaundice, 7 had pyrexia >39 degrees, 7 had conjunctival suffusion,

6 had meningism,


7/9

Only 2 patients had borderline IgM ELISA i.e. 15-20 u/ml,

11 had positive results >20 u/ml and

Mean levels of IgM was 34u/ml. Two tested positive by PCR done at RMRC Port

Blair. All were treated with injection ceftriaxone for 7-

14 days, All recovered fully Discharged with normal hepato renal functions.


8/9

Total 7/13 patients had leptospirosisaccording to WHOs Faines criteria, with ascore of >25

Using modified Faines criteria all 13 werepositive with a score of >25.

Modified Faines criteria have been

recently suggested especially in Indiancontext to diagnose the leptospirainfection.


9/9

Documents

Leptospirosis in Himachal