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INTRODUCTION: Leptospirosis is an infection caused by spiral bacteria from the family Leptospiraceae, and is considered to be the most widespread zoonosis in the world. AIM: To analyze the clinical and laboratory characteristics of patients with Leptospirosis over five years. METHODS: The study included 160 patients aged 17-79 years, who in the period 01.01.2014. to 21.12.2018. were hospitalized at the Clinic for Infectious Diseases of the University Clinical Center Tuzla. They were diagnosed based on medical history, clinical examination, laboratory and microbiological results. The definitive diagnosis was confirmed by serological testing from the patients' blood. RESULTS: In the observed period, the highest number of patients were in 2014 80/160, and the lowest in 2015 15/160. Male patients were more likely to suffer from 118 (73.8%) than female 42 (26,3%). The mean age was ±56.5 years. The most common symptoms in patients were: fever (95,6%), headache (93,8%), malaise (87,5%) and myalgia (85,6%). In all patients, 160/160 (100%) accelerated erythrocyte sedimentation and elevated C-reactive protein was observed. The following findings were reported from white blood cell findings: leukocytosis in 81/160 (50,6%), neutrophilia in 103/160 (64,4%) and lymphopenia in 128/160 (80%) patients. Liver findings had the following values: elevated AST in 142/160 (88%) and ALT in 130/160 (81,3%) patients. Total bilirubin was elevated in 105/160 (65,6%) and direct in 107/160 (66,9%). Thrombocytopenia was in 142/160 (88%) patients. Urea was elevated in 103/160 (64,4%) and creatinine in 101/160 (61,3%) patients. CONCLUSION: it is very important that physicians in their day to day practice, especially in ambiguous febrile conditions, differentially diagnose leptospirosis and establish a timely diagnosis, this is ley to adequate and timely therapy, and therefore to reducing to development of complications and mortality.
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Animal leptospirosis, exempt in rodents, manifests as peculiar biology where the animal can function, simultaneously or not, as a susceptible host or reservoir. In the first case, clinical symptoms are likely. In the second case, infection is subclinical and manifestations are mild or absent. Mild clinical symptoms encompass reproductive failure in production animals for host-adapted Leptospira sp. serovars. This work presents a study on Leptospira sp. infection in a mixed-species (bovine and swine) farm with documented reproductive disorders in the cattle unit. A long calving interval (above 450 days) was the hallmark observed in cows. Some cows (2/26 tested) presented a high titre of antibodies against Leptospira sp. serogroup Sejroe, but the overall within-herd prevalence was low (11.5% and 7.7% for cut-off titres of 1:30 and 1:100, respectively). The in-herd prevalence of leptospirosis in the sow unit (determined for 113/140 animals) was high when using a lowered cut-off threshold (32.7% vs. 1.8% for cut-off titre of 1:30 and 1:100, respectively). In this unit, the most prevalent serogroup was Autumnalis. The final diagnostic confirmation of Leptospira sp. maintenance within the farm was obtained through detection by PCR of Leptospira sp. DNA in an aborted swine litter. Despite the fact that a common causative infective agent was diagnosed in both species, the direct link between the two animal units was not found. Factors such as drinking from the same water source and the use of manure prepared with the swine slurry might raise suspicion of a possible cross-contamination between the two units. In conclusion, this work suggests that leptospirosis be included in the differential diagnosis of reproductive disorders and spontaneous abortions in production animals and provides data that justify the use of a lowered threshold cut-off for herd diagnosis.