Atypical lymphocytosis in leptospirosis: a cohort of hospitalized cases between 1996 and 2009 in State of Rio de Janeiro, Brazil

Leptospirosis is a zoonotic disease found in tropical and temperate countries, and its clinical diagnostic confusion with arboviruses (dengue fever, oropouche fever and yellow fever), Brazilian spotted fever, viral hepatitis and hantaviruses has been an ongoing public health concern. The aim of this...

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Published in:Revista da Sociedade Brasileira de Medicina Tropical 2011-10, Vol.44 (5), p.611-615
Main Authors: Damasco, Paulo Vieira, Avila, Carlos André Lins, Barbosa, Angélica Tápia, Ribeiro Carvalho, Marilza de Moura, Pereira, Geraldo Moura Batista, Lemos, Elba Regina Sampaio de, Bóia, Márcio Neves, Pereira, Martha Maria
Format: Article
Language:English
Subjects:
Adult
Brazil
Características clínicas
Cohort Studies
Female
Flow Cytometry
Humans
Immunophenotyping
Leptospirose
Leptospirosis - complications
Leptospirosis - immunology
Linfócitos atípicos
Linfócitos gama-delta
Lymphocytosis - etiology
Lymphocytosis - immunology
Male
Middle Aged
Mortality
Observational studies
Public health
Retrospective Studies
T-Lymphocytes - immunology
TROPICAL MEDICINE
Vector-borne diseases
Young Adult
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Summary:Leptospirosis is a zoonotic disease found in tropical and temperate countries, and its clinical diagnostic confusion with arboviruses (dengue fever, oropouche fever and yellow fever), Brazilian spotted fever, viral hepatitis and hantaviruses has been an ongoing public health concern. The aim of this observational study was to demonstrate an association between findings of atypical lymphocytosis and the progression of endemic leptospirosis. A retrospective analysis was performed on the demographic, epidemiological, clinical and laboratory aspects of 27 human leptospirosis cases that occurred over a period of 13 years (1996-2009) with no reported epidemic outbreaks in Rio de Janeiro, Brazil. The overall mortality rate was 11.1% in our cohort of hospitalized cases. However, there was no mortality among patients with atypical lymphocytosis (OR = 11.1; 95% CI = 1.12-110.9; p = 0.04). Two patients who were in the septicemic phase showed signs of expansion of γδ T cell responses in peripheral blood. Atypical lymphocytosis may be observed in patients with leptospirosis. Our observations suggest that these atypical leukocyte subsets are associated with partial protection during the disease course of leptospirosis.
ISSN:0037-8682
1678-9849
1678-9849
DOI:10.1590/S0037-86822011005000050