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Volume 16, Number 2—February 2010

Dispatch

Severe Leptospirosis in Hospitalized Patients, Guadeloupe

Cécile Herrmann-StorckComments to Author , Magalie Saint Louis, Tania Foucand, Isabelle Lamaury, Jacqueline Deloumeaux, Guy Baranton, Maurice Simonetti, Natacha Sertour, Muriel Nicolas, Jacques Salin, and Muriel Cornet
Author affiliations: Guyane University, Guadeloupe, French West Indies (C. Herrman-Storck, M. Saint Louis, T. Foucand, I. Lamaury, J. Deloumeaux, M. Simonetti, M. Nicholas, J. Salin); Institut Pasteur, Paris, France (G. Baranton, N. Serour, M. Cornet); and Paris Descartes University, Paris (M. Cornet)

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Table 2

Laboratory findings for 168 case-patients with confirmed leptospirosis, Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies, 2003–2004*

Laboratory findings Univariate analysis
Multivariate analysis
All case-patients, N = 168† Case-patients with severe disease, n = 24† Case-patients with nonsevere disease, n = 144† p value
OR (95% CI) p value
Prothrombin time <70% 10/118 (8.5) 5/21 (23.8) 5/97 (5.1) 0.01 0.7 (0.05–9.8) 0.077
Thrombocytopenia, <50 × 109 cells/L 25/135 (18.5) 8/23 (34.8) 17/112 (15.2) 0.02 1 (0.1–2.4) 0.96
Hyperneutrophilia, >12 × 109 cells/L 24/136 (17.6) 10/23 (43.5) 14/113 (12.4) 0.01 0.9 (0.1–7.1) 0.93
ALT >119 U/L 30/108 (27.8) 6/23 (26.1) 24/85 (28.2) 0.8
AST >102 U/L 58/128 (45.3) 17/23 (73.9) 41/105 (39) 0.02 4.3 (1.2–14.6) 0.021
CPK >1000 U/L 22/108 (20.4) 5/18 (27.8) 17/90 (18.9) 0.4
LDH >800 U/L 11/101 (10.9) 3/17 (17.6) 8/84 (9.5) 0.3
Amylase >285 U/L 16/82 (19.5) 8/15 (53.3) 8/67 (11.9) <0.001 18.5 (3.8–88.8) <0.001
Lipase >60 U/L
7/40 (17.5)
2/8 (25)
5/32 (15.6)
0.8



Hemoglobin, g/dL 12.9 ± 0.6 (136) 11.1 ± 2.0 (23) 13.2 ± 3.4 (113) 0.01
Hemoglobin <10 g/dL
13/136 (9.5)
5/23 (21.7)
8/113 (7.1)
0.04

2.3 (0.5–9.8)
0.2
Bilirubin, mg/dL 8.3 ± 2.3 (86) 15.2 ± 11.7 (18) 5.8 ± 7.2 (68) <0.001
Bilirubin >7 mg/dL
31/86 (36.0)
13/18 (72.2)
18/68 (26.4)
<0.001

0.48 (0.05–4.7)
0.6
Potassium, mmol/L 4.0 ± 0.22 (136) 3.8±.9 (23) 4.0 ± 1.3 (113) 0.5
Sodium, mmol/L
133.5 ± 4.2 (136)
132.8 ± 5.3 (23)
133.6 ± 3.9 (113)
0.5



Creatinine, mg/d 2.0 ± 0.3 (130) 2.8 ± 2.5 (21) 1.9 ± 2.0 (109) 0.05 2.0 (0.6–6.6) 0.2
Creatinine >1.5 mg/dL
54/130 (41.5)
11/21 (52.4)
43/109 (39.4)
0.2



Urea nitrogen mg/dL
69.0 ± 10.2 (136)
85.8 ± 76.2 (23)
64.2 ± 64.2 (113)
0.5



Isolation of Leptospira in 
blood culture 55/88 (62.5) 8/14 (57.1) 47/74 (63.5) 0.3
L. interrogans serovar 
 Icterohemorrhagiae 18/40‡ (45) 6/8 (75) 12/32 (37.5) 0.06 5.3 (1.0–26.0) 0.004
L. borgpetersenii serovar 
 Castellonis 5/40‡ (12.5) 0/8 5/32 (15.6) 0.1
L. borgpetersenii serovar
 Arborea 9/40‡ (22.5) 2/8 (25) 7/32 (21.9) 0.6
L. kirschneri serovar 
 Bogvere 6/40‡ (15) 0/8 6/32 (18.7) 0.1
L. santarosai serovar 
 Tabaquite 2/40‡ (5) 0/8 2/8 (25) 0.4

*OR, odds ratio; CI, confidence interval; ALT, alanine aminotransferase; AST, aspartate aminotransferase; CPK, creatinine phosphokinase; LDH, lactate dehydrogenase. Boldface indicates significance.
†Mean ± SD (examined) or no. case-patients/no. examined (%).
‡Serovar identification was completed for 40 of the 55 Leptospira strains isolated.

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