RESUMEN
Samples of cerebrospinal fluid from 103 patients with aseptic meningitis were tested by PCR for detection of leptospires, and the results were compared with those of the microscopic agglutination test (MAT) and an enzyme-linked immunosorbent assay for detection of immunoglobulin M (ELISA-IgM). Of these samples, 39.80% were positive by PCR and 8.74 and 3.88% were positive by MAT and ELISA-IgM, respectively.
Asunto(s)
Leptospira/aislamiento & purificación , Leptospirosis/líquido cefalorraquídeo , Meningitis Aséptica/líquido cefalorraquídeo , Adolescente , Adulto , Distribución por Edad , Niño , Preescolar , ADN Bacteriano/análisis , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Lactante , Leptospirosis/complicaciones , Masculino , Meningitis Aséptica/complicaciones , Meningitis Aséptica/microbiología , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa/métodosRESUMEN
14 cases that were admitted to the Hospital Universitario de Caracas, between 1.989 and 1.994, with a definitive diagnosis of Leptospirosis by microaglutination of live antigens were studied. Most of them hospitalized at the gastroenterology service. The serovar most frequently found was icterohemorragiae 11 cases. There was a predominium for the male gender 12/2 and the majority of patients belonged to the range of age between 31 and 40. The most common forms of presentations were: fever (14), jaundice (10) and myalgias (10) while the most relevant findings at physical examination were: jaundice (12), fever (11) and hepatomegaly (8). All patients had abnormal laboratory tests and among these, aminotransferases, bilirrubin, creatinin, CPK, platelets and urinary sediment were more frequently altered. Only half of the patients were diagnosed as Leptospirosis at the moment of admission. We conclude that even though Leptospirosis is an infectious disease distributed worldwide only few cases are hospitalized and differential diagnosis is difficult because of diversity of clinical presentations and lack of laboratory resources. It is important for gastroenterologists because most of complicated cases present as jaundiced patients.
Asunto(s)
Leptospirosis/diagnóstico , Adulto , Diagnóstico Diferencial , Femenino , Humanos , Ictericia/diagnóstico , Leptospirosis/sangre , Leptospirosis/líquido cefalorraquídeo , Leptospirosis/orina , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , VenezuelaRESUMEN
From January 1st up to September 30th 1990, 77 patients with leptospirosis diagnosis confirmed by laboratory studies were admitted at the Infectious and Parasitic Disease Service of the Hospital das Clínicas of the Universidade Federal de Pernambuco. The neurological exam was abnormal in 70 of the patients (90.91%). The cerebrospinal fluid (CSF) examination was carried out on 67 (87%) of the patients; it was abnormal in 64 (95.52%) yielding hypercytosis in the majority of cases. There was no difference in the CSF behavior in report to the several neurological forms nor in relation to the icteric or non-icteric forms of the disease. Significant were the results for the microscopic agglutination tests for leptospirosis in the CSF.
Asunto(s)
Enfermedades del Sistema Nervioso Central/líquido cefalorraquídeo , Leptospirosis/líquido cefalorraquídeo , HumanosRESUMEN
From January 1st up to September 30th 1990, 77 patients with leptospirosis were admitted at the Infectious and Parasitic Diseases Service of the Hospital das Clínicas of the Universidade Federal de Pernambuco. The majority (64) were male patients, and average age was 28 years old. Serovars icterohaemorrhagic and canicola were the most frequent. CSF examination was performed in 67 (87.0%) patients and it was abnormal in 64 (95.52%). Micro-agglutination test for leptospirosis with live antigens was performed in CSF, as well as immunological tests for syphilis, cysticercosis and schistosomiasis for differential diagnosis. Concerning the serovar identification, results of microagglutination test for leptospirosis in CSF were significant considering the similitude of responses when compared to those found for blood samples.
Asunto(s)
Enfermedades del Sistema Nervioso Central/diagnóstico , Leptospirosis/diagnóstico , Adolescente , Adulto , Anciano , Pruebas de Aglutinación , Antígenos Bacterianos/análisis , Antígenos Bacterianos/líquido cefalorraquídeo , Enfermedades del Sistema Nervioso Central/líquido cefalorraquídeo , Diagnóstico Diferencial , Femenino , Humanos , Leptospira/inmunología , Leptospirosis/líquido cefalorraquídeo , Masculino , Persona de Mediana EdadRESUMEN
Entre 1-janeiro e 30-setembro-1990 foram estudados 77 pacientes com diagnóstico de leptospirose, admitidos no SDIP/UFPE. O exame neurológico foi anormal em 70 (90,91 por cento) dos pacientes. O exame do LCR, foi realizado em 67 (87 por cento) dos pacientes, foi anormal em 64 (95,52 por cento), tendo como achado mais frequente a pleocitose. Näo houve diferença significativa no comportamento do LCR nas diversas formas clínicas neurológicas observadas, nem quando comparadas as formas ictéricas com as näo ictéricas. Bastante significativos foram os resultados da reaçäo de microaglutinaçäo para leptospirose no LCR
Asunto(s)
Humanos , Enfermedades del Sistema Nervioso Central/líquido cefalorraquídeo , Leptospirosis/líquido cefalorraquídeoRESUMEN
Entre 1-janeiro e 30-setembro-1990 foram estudados 77 pacientes com diagnóstico de leptospirose: 64 (83,11 por cento) eram do sexo masculino e a média de idade, 28 anos. Os sorovars icterohemorrhagiae e canicola foram os mais frequentes. O exame do LCR, realizado em 67 (87,0 por cento) dos pacientes, foi anormal em 64 (95,52//). A reaçäo de microaglutinaçäo para leptospirose com antígenos vivos foi realizada no LCR, bem como reaçöes imunológicas para sífilis, cisticercose e esquistossomose para diagnóstico diferencial. Bastante signficativa foram os resultados da reaçäo de microaglutinaçäo para leptospirose no LCR, pela semelhança das respostas àquelas encontradas no sangue quanto à identificaçäo do sorovar
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Enfermedades del Sistema Nervioso Central/diagnóstico , Leptospirosis/diagnóstico , Pruebas de Aglutinación , Antígenos Bacterianos/análisis , Antígenos Bacterianos/líquido cefalorraquídeo , Enfermedades del Sistema Nervioso Central/líquido cefalorraquídeo , Leptospira/inmunología , Leptospirosis/líquido cefalorraquídeoRESUMEN
Se analizó el cuadro clínico y la epidemiología de 36 casos del leptospirosis hospitalizados durante los meses de verano 1983-1984, los que se estudiaron por reacción de aglutinación microscópica usando 8 a 12 antígenos. No hubo relación entre el serotipo y la forma clínica. El cuadro clínico fue variado desde una evolución febril corta o otras con compromiso hepático renal y meningitis aséptica. Los serotipos más frecuentes fueron L. grippotyphosa, L. ballum, L. canícola y L. autumnalis lo que difiere de estudios anteriores hechos en este hospital. La evolución fue benigna en todos los casos. Para el mejor conocimiento de los diferentes cuadros clínicos que se producen en el curso de la infección por leptospiras, es necesario la comprobación por el laboratorio, mediante procedimientos que actualmente tienen un alto costo