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 Cornet
Table 1
Demographic, epidemiologic, and clinical characteristics as a function of severity among 168 case-patients with confirmed leptospirosis, Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies, 2003–2004*
| Characteristics |
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 |
||||||
| Male sex | 143/168 (85.1) | 18/24 (75) | 125/144 (86.8) | 0.2 | 2.6 (0.4–17.7) | 0.3 | |
| Age, y, mean ± SD (no. patients) | |||||||
| F | 58.5 ± 17.9 (25) | 55.5 ± 2.4 (6) | 36.7 ± 8 (19) | 0.05 | |||
| M |
47 ± 15.9 (143) |
51.8 ± 6.5 (18) |
49.6 ± 2.9 (125) |
0.5 |
|||
| Exposure to occupational risk‡ | 74/133 (55.6) | 12/20 (60) | 62 /113 (54.8) | 0.6 | |||
| Contact with swine | 41/115 (35.6) | 5/10 (50) | 36/105 (34.2) | 0.5 | |||
| Contact with cattle | 36/113 (31.9) | 1/10 (10) | 35/103 (34) | 0.8 | |||
| Contact with rodents |
56/114 (49.1) |
3/9 (33.3) |
53/105 (50.5) |
0.5 |
|||
| Medical history | |||||||
| Duration of illness before antibacterial therapy§ >10 d | 21/141 (14.9) | 7/22 (31.8) | 14/119 (11.8) | 0.01 | 4.8 (1.1–20.2) | 0.032 | |
| Diabetes mellitus | 13/75 (17.3) | 3/22 (13.6) | 10/53 (18.9) | 0.5 | |||
| Chronic hypertension ¶ | 24/75 (32) | 9/22 (40.9) | 15/53 (28.3) | 0.2 | 30.9 (6.0–157.4) | <0.001 | |
| Chronic alcoholism# |
29/75 (38.7) |
11/22 (50.0) |
18/53 (34) |
0.2 |
16.8 (4.1–57.9) |
<0.001 |
|
| Initial features | |||||||
| Hypothermia (<36.5°C) | 28/144 (19.4) | 7/23 (30.4) | 21/121 (17.3) | 0.1 | 4.6 (0.9–24.6) | 0.07 | |
| Hyperthermia (>37.7°C) | 82/144 (56.9) | 10/23 (43.5) | 72/121 (59.5) | 0.1 | 3.8 (0.7–21.2) | 0.12 | |
| Hypotension, SBP <100 mm Hg | 24/143 (16.8) | 7/20 (35) | 17/123 (13.8) | 0.02 | 0.3 (0.1–1.8) | 0.2 | |
| Myalgia | 73/77 (94.8) | 12/13 (92.3) | 61/64 (95.3) | 0.6 | |||
| Consciousness disorders | 10/119 (8.4) | 4/13 (30.8) | 6/106 (5.7) | 0.01 | 3.8 (1.1–13.2) | 0.035 | |
| Nuchal rigidity | 10/116 (8.6) | 2/12 (16.7) | 8/104 (7.7) | 0.2 | |||
| Headache | 70/91 (76.9) | 5/7 (71.4) | 65/84 (77.4) | 0.7 | |||
| Conjunctival suffusion | 46/116 (39.6) | 4/12 (33.3) | 42/104 (40.4) | 0.4 | |||
| Icterus | 57/117 (48.7) | 9/12 (75) | 48/105 (45.7) | 0.1 | 5.9 (1.1–31.1) | 0.036 | |
| Hemorrhage** | 15/165 (9.1) | 5/24 (20.8) | 10/141 (7.1) | 0.04 | 4.2 (0.3–67.9) | 0.31 | |
| Hepatosplenomegaly | 30/86 (34.9) | 7/11 (63.6) | 23/75 (30.7) | 0.02 | 1.7 (0.2–13.9) | 0.62 | |
| Abdominal pain | 64/124 (51.6) | 14/18 (77.8) | 50/106 (47.2) | 0.009 | 3 (0.7–13.2) | 0.139 | |
| Digestive disorders (diarrhea, vomiting) | 66/105 (62.8) | 12/15 (80) | 54/90 (60) | 0.2 | 3.5 (0.7–18.0) | 0.12 | |
| Abnormalities at chest auscultation†† | 19/135 (14.1) | 8/17 (47) | 11/118 (9.3) | <0.001 | 8.7 (1.8–41.3) | 0.006 | |
| Chest radiologic anomalies‡‡ | 22/112 (19.6) | 6/16 (37.5) | 16/96 (16.7) | 0.05 | 0.8 (0.1–10.4) | 0.85 | |
| Alveolar infiltrate | 9/112 (8.0) | 5/16 (31.2) | 4/96 (4.2) | <0.001 | |||
| Electrocardiographic disorders§§ | 22/73 (30.1) | 5/16 (31.2) | 17/57 (29.8) | 0.9 | |||
| Oliguria¶¶ or anuria | 34/128 (26.6) | 10/23 (43.5) | 24/105 (22.9) | 0.04 | 5.6 (1.5–20.6) | 0.009 | |
*OR, odds ratio; CI, confidence interval; SBP, systolic blood pressure. Boldface indicates significance.
†All values no. case-patients/no. examined (%) except as indicated.
‡Farming, livestock farming, construction, and gardening.
§Ampicillin or cefotaxime.
¶As reported by patients with specific therapy.
#Defined as alcohol dependence.
**Hemoptysis, hematuria, purpura, bleeding of the gums, and hematemesis.
††Crackles or ronchi.
‡‡Only anomalies of the lungs.
§§Excluding patients >60 y of age or with sinus tachycardia.
¶¶Urinary volume <400 mL/d.
Page created: December 10, 2010
Page updated: December 10, 2010
Page reviewed: December 10, 2010
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
Content Credential