Pulmonary haemorrhage as a frequent cause of death among patients with severe complicated Leptospirosis in Southern Sri Lanka

Background Leptospirosis is a tropical disease associated with life threatening complications. Identifying clinical and investigation-based parameters that predict mortality and morbidity is vital to provide optimal supportive care Methods We conducted an observational study in an endemic setting, i...

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Published in:PLoS neglected tropical diseases 2023-10, Vol.17 (10), p.e0011352-e0011352
Main Authors: Fonseka, Chathuranga Lakmal, Dahanayake, Niroshana Jathun, Mihiran, Denagama J. D, Wijesinghe, Kalani Mithunika, Liyanage, Lakshani Nawanjana, Wickramasuriya, Hesaru S, Wijayaratne, Gaya Bandara, Sanjaya, Kelum, Bodinayake, Champica K
Format: Article
Language:English
Subjects:
Agglutination tests
Biology and Life Sciences
Care and treatment
Causes of
Consent
Creatinine
Failure
Fatalities
Fever
Fibrillation
Haemoglobin
Haemorrhage
Health services
Heart diseases
Hemodynamics
Hemoglobin
Hemorrhage
Hypoxia
Instability
Kidney diseases
Laboratories
Leptospirosis
Liver
Liver failure
Medicine and Health Sciences
Morbidity
Mortality
Myocarditis
Observational studies
Oliguria
Parameter identification
Parameters
Patient outcomes
Patients
Regression analysis
Stability
Teaching hospitals
Urine
Ventilation
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Summary:Background Leptospirosis is a tropical disease associated with life threatening complications. Identifying clinical and investigation-based parameters that predict mortality and morbidity is vital to provide optimal supportive care Methods We conducted an observational study in an endemic setting, in the southern Sri Lanka. Consecutive patients having complicated leptospirosis were recruited over 18 months. Clinical, investigational and treatment data were collected and the predictors of mortality were analysed. Results Out of 88 patients having complicated leptospirosis, 89% were male. Mean age was 47yrs (±16.0). Among the total major complications 94.3% had acute kidney injury, 38.6% pulmonary haemorrhages, 12.5% fulminant hepatic failure, 60.2% hemodynamic instability and 33% myocarditis. An acute significant reduction of haemoglobin (Hb) was observed in 79.4% of patients with pulmonary haemorrhage. The mean of the highest haemoglobin reduction in patients with pulmonary haemorrhage was 3.1g/dL. The presence of pulmonary haemorrhage (PH) and hemodynamic instability within first 48 hours of admission significantly predicted mortality (p
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0011352