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Volume 17, Number 9—September 2011

Research

Leptospirosis as Frequent Cause of Acute Febrile Illness in Southern Sri Lanka

Megan E. RellerComments to Author , Champika Bodinayake, Ajith Nagahawatte, Vasantha Devasiri, Wasantha Kodikara-Arachichi, John J. Strouse, Judith E. Flom, J. Stephen Dumler, and Christopher W. Woods
Author affiliations: Author affiliations: Johns Hopkins University School of Medicine, Baltimore, Maryland, USA (M.E. Reller, J.J. Strouse, J.S. Dumler); University of Ruhuna, Galle, Sri Lanka (C. Bodinayake, A. Nagahawatte, V. Devasiri, W. Kodikara-Arachichi); Johns Hopkins School of Public Health, Baltimore (J.E. Flom); Duke University School of Medicine, Durham, North Carolina, USA (C.W. Woods)

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Table 2

Clinical characteristics of febrile patients with acute leptospirosis versus those without acute leptospirosis, southern Sri Lanka, 2007*

Clinical characteristic With acute leptospirosis, n = 120 Without acute leptospirosis, n = 653 p value
Symptom
Headache 81 78 0.63
Sore throat 28 29 0.96
Cough 44 60 <0.005
Dyspnea 15 18 0.48
Joint pain 56 43 <0.01
Muscle pain 62 46 <0.005
Lethargy 58 70 <0.01
Abdominal pain 22 18 0.41
Emesis 45 37 0.10
Diarrhea 13 12 0.80
Dysuria 20 13 <0.05
Oliguria
17
8
<0.005
Sign
Mean temperature, °C (SD) 38.6 (0.6) 38.5 (0.6) 0.17
Median heart rate, beats/min (IQR) 80 (72–100) 84 (76–96) 0.85
Mean body mass index, kg/m2 (SD) 20.7 (4.8) 19.6 (5.1) <0.05
Conjunctival suffusion 29 12 <0.0005
Pharyngeal exudate 8 15 <0.05
Lymphadenopathy 24 23 0.73
Jaundice 2 2 0.73
Lung crackles 10 14 0.27
Tender abdomen 13 9 0.21
Hepatomegaly
8
5
0.31
Laboratory parameter, median (IQR)
Leukocytes, cells/μL 7,800 (5,700–10,500) 7,900 (5,600–11,300) 0.52
Absolute neutrophil count, cells/μL 5,530 (3,854–8,424) 5,313 (3,344–7,952) 0.49
Absolute lymphocyte count, cells/μL 1,638 (1,210–2,574) 2,140 (1,541–2,856) <0.005
Hemoglobin, g/dL 12.3 (11.6–13.5) 12.6 (11.7–13.8) <0.05
Platelets, × 1,000/μL 200 (164–256) 231 (190–289) <0.0005

*Values are % patients in that category (with vs. without leptospirosis), except as indicated. IQR, interquartile range.

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