Intensive Care Medicine

, Volume 33, Issue 11, pp 1959–1966 | Cite as

Leptospirosis in Reunion Island (Indian Ocean): analysis of factors associated with severity in 147 confirmed cases

  • Fabrice Paganin
  • Arnaud Bourdin
  • Cécile Dalban
  • Jean-Paul Courtin
  • Patrice Poubeau
  • Gianandrea Borgherini
  • Alain Michault
  • Jean-Claude Sally
  • François Tixier
  • Robert Genin
  • Claude Arvin-Berod
Original

Abstract

Objective

Analysis of risk factors associated with severity in patients with confirmed leptospirosis.

Design and setting

Retrospective study in 147 leptospirosis-confirmed patients at two tertiary nonteaching hospital in Reunion Island.

Patients

138 men and 9 women, aged 36 ± 14 years, 80 in the ICU and 67 in medical wards.

Measurements and results

We collected demographic, clinical, biological, and radiographic data and performed univariate and multivariate analysis to examine risk factors associated with admission in ICU and mortality. Pulmonary forms were more frequent (85%) than in previous reports, with 85 cases (65.3%) on abnormal chest radiography. Among the 38 patients who underwent bronchoalveolar lavage at admission 31 (81.5%) had alveolar hemorrhage. Independent factors related to ICU admission were: age over 46 years (OR 3.02), creatinine higher than 200 μmol/l (6.69), shock (13.87), and acute respiratory failure (20.69). Mortality was 12.9%. The only factor independently related to mortality was need for mechanical ventilation (OR 20.94). Icterohemorrhagiae serogroup was found in 62 cases (42.8%) but was not related to death.

Conclusions

Pulmonary involvement is a major feature in leptospirosis disease but is not associated with poor outcome. Identification of clinical and laboratory findings on admission may help to better characterize severe cases.

Keywords

Leptospirosis Pulmonary manifestations Risk factor Mortality Intensive care Alveolar hemorrhage 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Fabrice Paganin
    • 1
  • Arnaud Bourdin
    • 1
  • Cécile Dalban
    • 2
  • Jean-Paul Courtin
    • 1
  • Patrice Poubeau
    • 1
  • Gianandrea Borgherini
    • 1
  • Alain Michault
    • 3
  • Jean-Claude Sally
    • 4
  • François Tixier
    • 5
  • Robert Genin
    • 6
  • Claude Arvin-Berod
    • 1
  1. 1.Service de Pneumologie et Maladies InfectieusesGHSRSt. Pierre, RéunionFrance
  2. 2.Centre d’Investigation CliniqueGHSRSt. Pierre, RéunionFrance
  3. 3.Service de BiologieGHSRSt. Pierre, RéunionFrance
  4. 4.Service de BiologieCHD Félix GuyonSt. Denis, RéunionFrance
  5. 5.Service de RéanimationGHSRSt. Pierre, RéunionFrance
  6. 6.Service de NéphrologieCHD Félix GuyonSt. Denis, RéunionFrance

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