Volume 16, Number 2—February 2010
Dispatch
Severe Leptospirosis in Hospitalized Patients, Guadeloupe
Cécile Herrmann-Storck
, Magalie Saint Louis, Tania Foucand, Isabelle Lamaury, Jacqueline Deloumeaux, Guy Baranton, Maurice Simonetti, Natacha Sertour, Muriel Nicolas, Jacques Salin, and Muriel Cornet
, Magalie Saint Louis, Tania Foucand, Isabelle Lamaury, Jacqueline Deloumeaux, Guy Baranton, Maurice Simonetti, Natacha Sertour, Muriel Nicolas, Jacques Salin, and Muriel CornetTable 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.
