Death Audit of Leptospirosis Cases in Surat and Navsari District of South Gujarat
Keywords:
Leptospirosis, Weils’ disease, oliguric renal failure, ARDSAbstract
Introduction: Leptospirosis, zoonotic disease with very wide geographical distribution, is likely to be missed due to its wide spectrum of symptoms which may mimic the clinical signs of many other diseases. The present study was carried out to study the epidemiology, clinical and laboratory profile of died patients with confirm leptospirosis in Surat and Navsari Districts.
Methods and Material: A household visits were done for all leptospirosis confirmed death cases of Surat and Navsari district during 15th June to 31st Oct 2012.
Result: Out of 13 patients all were male, 10(76.9%) were in age group (20-45 years), 11 (84.6%) patients had history of exposure while working in farm in last 15 days and 12 (92.3%) patients had received Doxycycline chemoprophylaxis in current year. Most common presenting symptoms were fever (100%) followed by calf muscle myalgia (92.3%), jaundice (92.3%) and Oliguria (92.3%). Mean serum billirubin level, SGPT, SGOT, Serum blood Urea and creatinin were 13.7mg/dl, 111.5 IU/l, 139.7 U/l, 184.85mg/dl and 4.5mg/dl respectively. Severe anemia, thrombocytopenia and co-agulopathy were found in all cases. The average duration between onset of the symptoms and first medical consultation was 3.1 days and duration between onset of symptoms and first dose of antibiotics was 3.7 days.
Conclusion: Hepatic dysfunction, acute renal failure, co-agulopathy, ARDS were the commonest presentation requiring artificial ventilation among deceased Leptospirosis cases. Delay in medical consultation and first dose of antibiotics may be a reason for Multi-organ dysfunction in these cases.
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