EVALUATION OF DIFFERENT LABORATORY PARAMETERS IN THE DIAGNOSIS OF LEPTOSPIROSIS

BACKGROUND: Leptospirosis is one among the many zoonotic diseases that have emerged and resulted in epidemics leading to significant morbidity and mortality in humans. Even though it is a potentially serious disease it can be treated. Early diagnosis and appropriate treatment will halt the progression of the disease and reduce the mortality and morbidity of leptospirosis. So awareness and knowledge about the clinical and laboratory profile of leptospirosis is valuable so that a quick clinical suspicion can be made out and diagnosed early for initiating appropriate treatment and for a better outcome. MATERIALS AND METHODS: Patients admitted with fever = 5 days and of the age group eleven years and above were evaluated for leptospirosis by performing MSAT (Macroscopic slide agglutination test). 156 patients who were positive by MSAT were taken into the study and the period of study was one year. These patients were subjected to detailed evaluation and followed till death or discharge. The data of these patients were tabulated and analysed using simple statistical methods. MAT (Microscopic agglutination Test) was performed with all MSAT positive samples to determine the predominant serovar. RESULTS: Out of 156 patients 51.28% were males and the mean age group affected was 21 to 30 yrs. Predominant symptoms were fever (100%), coloured urine (62.82%), vomiting (48.07%) and headache (40.38%). On examination, icteric sclera was seen in 71.79%, and hepatomegaly in 32.69% of patients. The common serovars were Leptospira icterohaemorrhagiae (49.65%), Leptospira. australis (28.64%), Leptospira. semaranga (13.28%). Incidence of leptospirosis was seen throughout the year although the number of cases increased during monsoon season (August to February). Laboratory investigations revealed elevated ESR in 100%, thrombocytopenia in 50.64%, increased polymorphs in 66.66%, abnormal LFT (Liver Function Tests) in 71.79%, abnormal RFT (Renal Function Tests) in 26.92% and both abnormal LFT and RFT in 21.79% of patients. Two patients (1.28%) went into acute renal failure. Renal parameters were found to be increased (90.47%) more in thrombocytopenic patients. Pulmonary involvement was present only in 2.56% of patients. DISCUSSION AND CONCLUSION: In conclusion this study provides clinical and laboratory data describing the extent of the problem of leptospirosis which can be used for quick clinical judgement and suspicion of leptospirosis in future cases, particularly in communities which lack diagnostic facilities. L. icterrohaemorrhagiae (49.65%) was the predominant serovar. There was no mortality observed in this study due to early recognition and intensive treatment, even in the severe form of disease.