DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20210428

Human leptospirosis in patients with undifferentiated acute febrile illness in a tertiary care hospital in New Delhi

Garima Gautam, Manoj B. Jais, Ravinder Kaur, Megh Singh Dhakkad

Abstract


Background: Leptospirosis is an important cause of febrile illness with a widespread global distribution. Although endemic in the southern and western states of India, its true incidence in the northern states of the country remains underreported. The main objective of this study was to estimate the seropositivity of infections by Leptospira in patients presenting with undifferentiated acute fever, in a tertiary care hospital in New Delhi.

Methods: This prospective observational study was conducted from November 2016 to March 2018 in a tertiary care hospital in New Delhi. Blood samples of the patients (n=370) having fever for more than one week and seronegative for typhoid, dengue, chikungunya and malaria were subjected to Leptospira IgM ELISA (DRG International Inc., USA). Data was analyzed using statistical software SPSS version 21.

Results: Out of 370 patients, 142 (38.4%) were males and 228 (61.6%) were females; the mean age was 32.18 years. The most common symptom was headache (55.5%) and icterus (55.55%) whereas increased ALT/AST was the most common laboratory finding (88.8%) followed by anaemia (77.7%). On employing Leptospira IgM ELISA, 2.43% (9 cases, n=370) were strongly reactive (>1.0 OD) whereas 15.1% (56 cases) were weakly reactive (1.15-1.00 OD).

Conclusions: There is a need to increase awareness and suspicion regarding diagnosis of leptospirosis. A positive IgM ELISA when correlated with patient’s clinical profile and epidemiological factors can aid in the timely diagnosis and treatment of these infections.

 


Keywords


Acute febrile illness, IgM Leptospira ELISA, Leptospirosis

Full Text:

PDF

References


Meslin FX. Global aspects of emerging and potential zoonoses: a WHO perspective. Emerg Infect Dis. 1997;3(2):223-8.

Chaudhry R, Premlatha MM, Mohanty S, Dhawan B, Singh KK, Dey AB. Emerging leptospirosis, North India. Emerg Infect Dis. 2002;8(12):1526-7.

Kaur IR, Sachdeva R, Arora V, Talwar V. Preliminary survey of leptospirosis amongst febrile patients from urban slums of East Delhi. J Assoc Physic India. 2003;51:249-51.

Chaudhry R, Das A, Premlatha MM, Choudhary A, Chourasia BK, Chandel DS, et al. Serological and molecular approaches for diagnosis of leptospirosis in a tertiary care hospital in north India: a 10-year study. Indian J Med Res. 2013;137(4):785-90.

Kumar SS. Indian guidelines for the diagnosis and management of human leptospirosis. API Medicine Update. 2013;23:23-9.

Ananthanarayan R, Paniker CK. Rickettsiaceae, Spirochetes. In: Textbook of Microbiology. 9th ed. Universities press; 2013: 380-384,405-414.

Budihal SV, Perwez K. Leptospirosis diagnosis: competancy of various laboratory tests. J Clin Diagn Res. 2014;8(1):199-202.

Niloofa R, Fernando N, de Silva NL, Karunanayake L, Wickramasinghe H, Dikmadugoda N, et al. Diagnosis of leptospirosis: comparison between microscopic agglutination test, IgM-ELISA and IgM rapid immunochromatography test. PLoS One. 2015;10(6).

Gupta N, Chaudhry R, Mirdha B, Das B, Dar L, Kabra S, et al. Scrub typhus and leptospirosis: the fallacy of diagnosing with IgM enzyme linked immunosorbant assay. J Microb Biochem Technol. 2016;71-5.

Bhatia M, Umapathy BL, Navaneeth BV. An evaluation of dark field microscopy, culture and commercial serological kits in the diagnosis of leptospirosis. Indian J Med Microbiol. 2015;33(3):416.

Venkatesh S, Chhabra M, Balakrishnan, Gupta N, Singhai M, Tiwari S, et al. Zoonotic diseases of public health importance. National Centre for Deisease Control, Delhi; 2016.

Phommasone K, Paris DH, Anantatat T, Castonguay-Vanier J, Keomany S, Souvannasing P, et al. Concurrent infection with murine typhus and scrub typhus in southern laos- the mixed and the unmixed. PLoS Negl Trop Dis. 2013;7(8).