Sociodemographic and clinical characteristics of patients infected with Leptospira spp. treated at four hospitals in Medellín, Colombia, 2008-2013

Abstract

Introduction: Leptospirosis remains a significant health problem in tropical regions including Latin America, where its presentation is 100 times higher than that observed in other regions of the world. Mortality reaches 10% in severe cases. Its diagnosis is challenging because clinical manifestations during the initial phase are non-specific and because of limited availability of diagnostic tests.
Objective: To describe the demographic and clinical characteristics and the outcomes in hospitalized patients with leptospirosis.
Materials and methods: This retrospective study included patients treated at four institutions in Medellín between January, 2009, and December, 2013, with a compatible clinical picture and a positive IgM for Leptospira spp.
Results: We included 119 patients, 80% male, and 58% of rural origin. The mean duration of symptoms was 9.6 days (SD=9.6). Eighty nine per cent of patients had fever; 62%, jaundice; 74%, myalgia; 46%, diarrhea; 41%, hepatomegaly; 13%, splenomegaly, and 13%, conjunctival injection. Fifty four per cent of patients had impaired renal function; 32%, pulmonary compromise, and 13%, liver failure. Sixteen per cent required admission to the ICU; 12%, mechanical ventilation, and 11%, vasopressor therapy.
Weil’s syndrome occurred in 38.6% and 5% died. The average hospital stay was 11 days (SD=9.6).
Conclusions: In this population, the clinical manifestations and complications of leptospirosis were similar to those reported in the literature. We observed a relatively low overall mortality in relation to global statistics.