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Volume 26, Number 9—September 2020
Dispatch

Anicteric Leptospirosis-Associated Meningitis in a Tropical Urban Environment, Brazil

Scott A. Nabity, Guilherme C. Araújo, José E. Hagan, Alcinéia O. Damião, Mitermayer G. Reis, Albert I. Ko, and Guilherme S. RibeiroComments to Author 
Author affiliations: Massachusetts General Hospital, Boston, Massachusetts, USA (S.A. Nabity); Instituto Gonçalo Moniz, Salvador, Brazil (G.C. Araújo, A.O. Damião, M.G. Reis, A.I. Ko, G.S. Ribeiro); Yale University, New Haven, Connecticut, USA (J.E. Hagan, M.G. Reis, A.I. Ko); Universidade Federal da Bahia, Salvador, Brazil (M.G. Reis, G.S. Ribeiro)

Main Article

Table 2

Characteristics of patients with leptospirosis-associated and non-leptospirosis meningitis, Salvador, Brazil*

Characteristic
 Confirmed leptospirosis-associated meningitis
Nonleptospirosis aseptic meningitis
No. patients
 No. (%) or mean ± SD (range)
 No. patients†
 No. (%) or mean ± SD (range)
 p value
Age, y
 5
 30.8 ± 9.9 (18–42)
13
 28.6 ± 13.4 (16–51)
 0.746‡
No. days of symptoms before hospital care
 5
 6.4 ± 1.8 (2–8)
13
 6.2 ± 5.3 (2–20)
 0.922‡
Symptom profile§
Emesis 5 4 (80.0) 13 8 (61.5) 0.615
Photophobia 5 1 (20.0) 13 0 0.278
Nuchal rigidity 5 1 (20.0) 13 5 (38.5) 0.615
Abdominal pain 5 2 (40.0) 13 2 (15.4) 0.533
Diarrhea 5 2 (40.0) 13 2 (15.4) 0.533
Myalgia/arthralgia
 5
 4 (80.0)
13
 6 (46.2)
 0.314
Total peripheral eukocytes,103/mL 5 9.8 ± 4.2 (4.9–15.5) 13 9.2 ± 1.2 (5.2–20.4) 0.800‡
Platelets, 103/μL
 5
 214.8 ± 98.6 (108–336)
13
 262.8 ± 52.6 (178–350)
 0.193‡
Plasma chemistries
Potassium, meq/L 4 4.5 ± 0.5 (4.1–5.2) 11 4.3 ± 0.5 (3.6–5.2) 0.504‡
Creatinine, mg/dL 5 1.1 ± 0.5 (0.6–1.8) 12 1.1 ± 0.3 (0.5–1.6) 0.910‡
ALT, U/L
 4
 42.8 ± 23.0 (25–76)
10
 33.6 ± 9.5 (12–49)
 0.297‡
Cerebrospinal fluid profile
Nucleated cells, 106/L 5 67.6 ± 48.2 (28–150) 13 351.3 ± 402.6 (17–1500) 0.025¶
Glucose, mg/dL 4 61.0 ± 13.7 (46–77)# 12 60.9 ± 11.6 (44–84) 0.991‡
Protein, g/L 5 35.4 ± 8.8 (23–46) 12 66.3 ± 31.3 (34–141) 0.014¶

*ALT, alanine aminotransferase.
†Analysis restricted to patients >15 y of age to avoid confounding of biochemical parameters by age.
‡2-sample t-test using pooled variance.
§All patients had severe headache and none had a seizure.
¶Wilcoxon sum-rank nonparametric test.
#Excludes 1 patient with type 2 diabetes who had a blood glucose of 298 and a cerebrospinal fluid glucose of 143.

Main Article

Page created: July 14, 2020
Page updated: August 19, 2020
Page reviewed: August 19, 2020
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