Seven Years Leptospirosis Follow-Up in a Critical Care Unit of a French Metropolitan Hospital; Role of Real Time PCR for a Quick and Acute Diagnosis
Abstract
:1. Introduction
2. Experimental Section
2.1. Study Design
2.2. Real-Time PCR Method
2.3. Clinical and Biological Data
3. Results
3.1. Epidemiological Data
3.2. Clinical and Biological Characteristics
3.3. Leptospirosis Sampling Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Age | Gender | Date (M/Y) | Main Symptoms | Biological Data | Samples (Results) | Delay between First Symptom and Sampling (Days) | Duration of ICU Hospitalization (Days) | Treatment Received | Outcome | Epidemiological Data |
---|---|---|---|---|---|---|---|---|---|---|
60 | M | September 2011 | Fever, myalgia; acute respiratory distress and acute kidney failure | Creatininemia: 516 µmol/L | PCR on blood and urine (positive)/no serology performed | 3 | 1 | Ceftriaxone | Death | Contact with stagnant water |
Elevated liver enzymes | ||||||||||
Thrombocytopenia: 81 G/L | ||||||||||
60 | F | April 2012 | Fever; vomiting; acute respiratory distress syndrome due to intra-alveolar hemorrhage, acute kidney failure and jaundice | Creatininemia: 405µmol/L | PCR on blood, urine, lung and liver post mortem biopsies (positive)/serology on day 9 (positive) | 7 | 2 | Ceftriaxone | Death | Unknown |
Elevated liver enzymes | ||||||||||
Bilirubinemia: 341µmol/L | ||||||||||
Thrombocytopenia: 8 G/L | ||||||||||
55 | M | July 2013 | Fever; myalgia, acute respiratory distress; acute kidney failure and jaundice | Creatininemia: 168 µmol/L | PCR on blood and urine (positive)/serology on day 6 (negative) | 6 | 3 | Ceftriaxone | Complete recovery | Swimming in a river |
Bilirubinemia: 706 µmol/L Thrombocytopenia: 12 G/L | ||||||||||
20 | M | August 2013 | Fever; myalgia, acute respiratory distress with intra alveolar hemorrhage; acute kidney failure and jaundice | Creatininemia: 124 µmol/L | PCR on blood and urine (positive)/serology on day 2 (negative) | 2 | 8 | Ceftriaxone | Complete recovery | Swimming in a river/skin lesions |
Bilirubinemia: 217 µmol/L Thrombocytopenia: 25 G/L | ||||||||||
43 | M | June 2014 | Fever, myalgia, arthralgia, diarrhea, cutaneous rash; Acute Kidney Failure | Creatininemia: 140 µmol/L | PCR on blood (positive) and urine (negative)/serology on day 7 (negative) | 4 | 8 | Ceftriaxone followed by Amoxicillin | Complete recovery | Consumption of stagnant water |
Elevated liver enzymes | ||||||||||
Rhabdomyolysis | ||||||||||
39 | M | July 2014 | Fever and jaundice | Bilirubinemia: 53 µmol/L | PCR on blood (positive) no urine sampling/serology on day 8 (negative) | 7 | 8 | Ceftriaxone followed by Doxycycline | Complete recovery | Swimming in a river |
Elevated liver enzymes Thrombocytopenia: 87 G/L | ||||||||||
49 | M | August 2014 | Fever, myalgia, diarrhea, acute respiratory distress with intra-alveolar hemorrhage requiring oro-tracheal intubation; acute kidney failure and jaundice | Creatininemia: 223 µmol/L | PCR on urine (positive) no plasma sampling/serology on day 7 (negative) and day 22 (positive) | 7 | 14 | Ceftriaxone | Complete recovery | Fishing |
Elevated liver enzyme | ||||||||||
Bilirubinemia: 405 µmol/L | ||||||||||
Anemia | ||||||||||
Thrombocytopenia: 10 G/L | ||||||||||
71 | F | August 2014 | Fever, diarrhea, acute kidney failure and jaundice | Creatininemia: 164 µmol/L | PCR on blood and urine (positive)/no serology performed | 4 | 6 | Ceftriaxone followed by Doxycycline | Complete recovery | Contact with stagnant water and consumption of water from a well |
Elevated liver enzymes | ||||||||||
Bilirubinemia: 278 µmol/L | ||||||||||
Thrombocytopenia: 57 G/L | ||||||||||
65 | M | November 2014 | Fever, acute kidney failure and jaundice | Creatininemia: 411 µmol/L | PCR on blood and urine (positive)/serology on day 30 (positive) | 6 | 3 | Ceftriaxone followed by Amoxicillin | Complete recovery | Hunting |
Elevated liver enzymes | ||||||||||
Bilirubinemia: 46 µmol/L | ||||||||||
Thrombocytopenia: 10 G/L | ||||||||||
58 | M | December 2014 | Fever, myalgia, arthralgia, acute kidney failure and jaundice | Creatininemia: 327 µmol/L | PCR on blood, urine and CSF (negative)/serology on day 17 (positive) | 10 | 4 | Amoxicillin and Ofloxacin | Complete recovery | Swimming in a river |
Elevated liver enzymes | ||||||||||
Bilirubinemia: 139 µmol/L | ||||||||||
Thrombocytopenia: 83 G/L | ||||||||||
37 | M | May 2015 | Fever, myalgia, rhabdomyolysis, acute kidney failure | Creatininemia: 210 µmol/L | PCR on blood (negative) and urine (positive)/serology on day 6 (positive) | 6 | 4 | Ceftriaxone | Complete recovery | Swimming in a river |
Elevated liver enzymes | ||||||||||
Thrombocytopenia: 139 G/L | ||||||||||
72 | M | June 2015 | Fever, myalgia, acute kidney failure requiring extra-renal purification, and jaundice | Creatininemia: 404 µmol/L Elevated liver enzymes Bilirubinemia: 177µmol/L Thrombocytopenia: 12 G/L Rhabdomyolysis | PCR on blood and urine (positive)/serology on day 3 (negative) | 3 | 8 | Ceftriaxone | Complete recovery | Hunting |
61 | M | July 2015 | Fever, myalgia, acute respiratory distress requiring oro-tracheal intubation, acute kidney failure with hematuria, and jaundice | Creatininemia: 656 µmol/L | PCR on blood and urine (positive)/no serology performed | 5 | 9 | Ceftriaxone followed by Amoxicillin | Complete recovery | Hunting and fishing |
Elevated liver enzymes | ||||||||||
Bilirubinemia: 406 µmol/L | ||||||||||
Thrombocytopenia: 15 G/L | ||||||||||
Anemia | ||||||||||
51 | M | July 2015 | Fever, myalgia, arthralgia, acute kidney failure and jaundice | Creatininemia: 257 µmol/L | PCR on blood (negative) and urine (positive)/serology on day 6 (negative) | 6 | 3 | Ceftriaxone | Complete recovery | Fishing |
Elevated liver enzymes | ||||||||||
Bilirubinemia: 31 µmol/L Thrombocytopenia: 102 G/L | ||||||||||
15 | M | September 2016 | Fever, myalgia, arthralgia, acute kidney failure and jaundice | Creatininemia: 137 µmol/L | PCR on blood (positive) and urine (negative)/no serology performed | 5 | 4 | Ceftriaxone | Complete recovery | Swimming in a river |
Elevated liver enzymes | ||||||||||
Bilirubinemia: 52 µmol/L Thrombocytopenia: 22 G/L | ||||||||||
62 | M | January 2017 | Fever, myalgia, arthralgia, rhabdomyolysis, acute kidney failure and jaundice | Creatininemia: 331 µmol/L | PCR on blood (negative) and urine (positive)/no serology performed | 8 | 2 | Ceftriaxone | Complete recovery | Gardening |
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Bahuaud, O.; Pastuszka, A.; Le Brun, C.; Ehrmann, S.; Lanotte, P. Seven Years Leptospirosis Follow-Up in a Critical Care Unit of a French Metropolitan Hospital; Role of Real Time PCR for a Quick and Acute Diagnosis. J. Clin. Med. 2020, 9, 3011. https://doi.org/10.3390/jcm9093011
Bahuaud O, Pastuszka A, Le Brun C, Ehrmann S, Lanotte P. Seven Years Leptospirosis Follow-Up in a Critical Care Unit of a French Metropolitan Hospital; Role of Real Time PCR for a Quick and Acute Diagnosis. Journal of Clinical Medicine. 2020; 9(9):3011. https://doi.org/10.3390/jcm9093011
Chicago/Turabian StyleBahuaud, Olivier, Adeline Pastuszka, Cécile Le Brun, Stephan Ehrmann, and Philippe Lanotte. 2020. "Seven Years Leptospirosis Follow-Up in a Critical Care Unit of a French Metropolitan Hospital; Role of Real Time PCR for a Quick and Acute Diagnosis" Journal of Clinical Medicine 9, no. 9: 3011. https://doi.org/10.3390/jcm9093011