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1.
Cent Eur J Public Health ; 29(3): 187-190, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34623117

RESUMO

OBJECTIVES: Potential effect of three environmental variables (population density of rodents, global weather in the form of the North Atlantic Oscillation (NAO) index, and acorn crop) on human morbidity rate of three zoonoses: tick-borne encephalitis (TBE), leptospirosis and tularaemia were analysed in the Czech Republic for the period 1970-1990. METHODS: The Pearson's correlation analysis was used. RESULTS: The correlation analysis revealed that the significant factor for explaining annual morbidity rates of these zoonoses was the abundance of common voles (Microtus arvalis) in the current year (for leptospirosis) or in the previous calendar year (for TBE and tularaemia). CONCLUSIONS: The two other environmental variables tested (NAO index and acorn production) do not seem to play a significant role in these zoonoses in Central Europe.


Assuntos
Encefalite Transmitida por Carrapatos , Leptospirose , Tularemia , Animais , Encefalite Transmitida por Carrapatos/epidemiologia , Incidência , Leptospirose/epidemiologia , Tempo (Meteorologia)
2.
Theriogenology ; 174: 121-123, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34428677

RESUMO

This study aims to evaluate the association between reproductive disorders and the main serogroups of Leptospira spp. in dairy herds. Blood samples from 216 cows from nine herds were collected for a Microscopic Agglutination Test (MAT), and a reproductive follow-up with ultrasonography was carried out monthly for at least 12 months. A total of 75 (16.5%) cows were reactive, while seroreactivity to a herd level ranged from 16.0% to 52.8%. Out of the nine herds, in five (55.0%) Sejroe was found to be the predominant serogroup and in four (45.0%) it was Icterohaemorrhagiae. The major reproductive problems identified were embryonic death (ED) and abortions. All herds presented ED and abortion was observed in three (33.3%). Herds with high seroreactivity (>20%) had more reproductive problems. Those with a predominance of Sejroe were associated with ED (P < 0.05), while those with Icterohaemorrhagiae were associated with abortion. The results show that different leptospiral strains lead to different reproductive problems, as well as showing that the main problem - ED - is caused by leptospirosis, particularly for those determined by strains of the serogroup Sejroe.


Assuntos
Doenças dos Bovinos , Leptospira , Leptospirose , Aborto Animal/epidemiologia , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Feminino , Leptospirose/epidemiologia , Leptospirose/veterinária , Gravidez , Sorogrupo
3.
Comp Immunol Microbiol Infect Dis ; 78: 101689, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34225227

RESUMO

Leptospirosis is the most widespread zoonosis worldwide, and it can cause reproductive failures in livestock, while in humans may vary from a mild fever to multi-organ failure and death. Due to this, in this study, we evaluated the usefulness of the segment encoding LigB C-terminus region, only present in pathogenic as target for a diagnostic PCR. This new PCR yielded a 100 % positivity for pathogenic Leptospira species and no cross-reactivity was found with intermediate or non-pathogenic species, or with other microorganisms, demostrating its high analytical specificity. The estimated analytical sensitivity was higher in serum samples than in blood or urine samples (6-9 × 102 lept/mL and 6-9 × 105 and 6-9 × 106 lept/mL, respectively). Multiple sequence alignment of the target region from different pathogenic Leptospira species confirmed that this gene region is highly conserved among these species, with few single nucleotide polymorphisms. The ligb-ct PCR here developed appears as a useful tool for the molecular diagnosis of leptospirosis.


Assuntos
Leptospira , Leptospirose , Animais , Leptospira/genética , Leptospirose/diagnóstico , Leptospirose/veterinária , Fases de Leitura Aberta , Reação em Cadeia da Polimerase/veterinária , Zoonoses
4.
J Med Case Rep ; 15(1): 358, 2021 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-34294111

RESUMO

BACKGROUND: Leptospirosis is an underdiagnosed bacterial infection with nonspecific symptoms, hence, a diagnostic challenge. Identifying a case of leptospirosis in Switzerland is uncommon. Although kidney complications are frequent in severe forms, including tubular dysfunction, observing this complication is rare in our country. We report the case of a patient with leptospirosis and kidney dysfunction, which was notable for proximal tubulopathy. This case report describes the diagnosis and management of this patient's tubular dysfunction. CASE PRESENTATION: A 34-year-old Caucasian male known for alcohol and drug abuse presented to our emergency department suffering from severe pain in the lower limbs, jaundice, and fever with flu-like symptoms. Physical examination was not contributory. Blood tests showed cytopenia, elevated inflammatory markers, acute kidney injury, and altered liver function tests with predominant cholestasis. Urinalysis showed proteinuria and significant glycosuria without concomitant hyperglycemia. Leptospirosis was suspected and confirmed by both positive serum polymerase chain reaction and elevated immunoglobulin M for Leptospira interrogans. The patient was treated with intravenous amoxicillin-clavulanate and doxycycline for 7 days. After antibiotic treatment, symptoms disappeared, and kidney dysfunction completely resolved. CONCLUSION: Our case focuses on the description of leptospirosis-related acute kidney injury with proximal tubular dysfunction, which is a rare finding in Switzerland.


Assuntos
Injúria Renal Aguda , Síndrome de Fanconi , Leptospira interrogans , Leptospirose , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Adulto , Síndrome de Fanconi/complicações , Síndrome de Fanconi/diagnóstico , Síndrome de Fanconi/tratamento farmacológico , Humanos , Leptospirose/complicações , Leptospirose/diagnóstico , Leptospirose/tratamento farmacológico , Masculino , Suíça
5.
Rev Soc Bras Med Trop ; 54: e00762021, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34231771

RESUMO

INTRODUCTION: Leptospirosis and brucellosis cause immunosuppression that worsens the clinical condition of people living with HIV/AIDS (PLWHA). We investigated the serological profile and risk factors of PLWHA. METHODS: Serum samples (n=238) were researched for Brucella spp. antibodies using Rose Bengal and tube agglutination tests and Leptospira spp. antibodies using the microscopic agglutination test. RESULTS: All samples were negative for Brucella spp. For leptospirosis, four samples (1.69%) were positive, and Andamana was the prevalent serovar. CONCLUSIONS: Low or no detection of these zoonoses does not reduce their importance in PLWHA. Vigilant, educational, and preventive measures should be adopted.


Assuntos
Brucelose , Infecções por HIV , Leptospira , Leptospirose , Testes de Aglutinação , Animais , Anticorpos Antibacterianos , Brasil/epidemiologia , Brucelose/complicações , Brucelose/epidemiologia , HIV , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Hospitais , Humanos , Leptospirose/complicações , Leptospirose/epidemiologia , Encaminhamento e Consulta , Fatores de Risco
6.
Front Cell Infect Microbiol ; 11: 677999, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34249775

RESUMO

The exact global impact of leptospirosis is unknown due to inadequate surveillance systems in place in most low-income countries. In this study, we analyzed the differences in mouse inflammatory signatures involved in pathogenic versus non-pathogenic Leptospira recognition at 24h and 72h post infection. Injection of C3H-HeJ mice with non-pathogenic L. biflexa increased circulation of a few chemokines (5/21, 24%) without secretion of cytokines in blood that resulted in engagement of resident macrophages, dendritic cells, neutrophils and NK cells without engagement of T cells. In contrast, pathogenic L. interrogans induced circulation of a much higher panel of chemokines (18/21, 86%) and pro- and anti-inflammatory cytokines (11/19, 58%) in blood with a resulting signaling cascade leading to engagement of macrophages, dendritic cells, monocytes, NK cells and T cells without engagement of neutrophils. Although neutrophils do not appear to be engaged, a considerable number of chemokines that recruit other granulocytes such as eosinophils and basophils were also increased at 72h post infection with L. interrogans. Overall, the data suggest that prevention of dissemination of L. biflexa is associated with an early engagement of the innate immune response characterized by upregulation of a few chemokines that results in an efficacious phagocytic response without an overwhelming increase of pro-inflammatory cytokines. However, when macrophages fail to clear a pathogenic serovar such as L. interrogans, the adaptive response (T cells) is engaged to help out, but the resulting chemo-cytokine storm mediates a robust but non-resolving inflammatory response to pathogenic Leptospira that results in dissemination, kidney colonization, pathology and disease.


Assuntos
Leptospira interrogans , Leptospira , Leptospirose , Animais , Quimiocinas , Imunidade Inata , Camundongos , Camundongos Endogâmicos C3H
7.
J Helminthol ; 95: e34, 2021 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-34250883

RESUMO

Strongyloidiasis and leptospirosis are neglected tropical diseases that have affected many countries across the world. In this study, we evaluated the seroprevalence of Strongyloides stercoralis among patients with leptospirosis in northern Iran. We evaluated 156 laboratory- or clinically confirmed leptospirosis cases. The overall seroprevalence of S. stercoralis was 32.0% (95% confidence interval (CI): 27.4-36.5%, 50/156). Seropositivity was significantly associated with agricultural activities (odds ratio (OR): 2.84, 95% CI: 1.0-8.77) and gastrointestinal disorders (OR: 2.4, 95% CI: 1.1-4.9). Laboratory findings indicated that seropositivity of S. stercoralis was significantly associated with decreased levels of platelet and elevated levels of creatinine, alanine aminotransferase and aspartate aminotransferase (P < 0.05). Our findings suggested a higher exposure to S. stercoralis larvae among patients with leptospirosis. The public health and medical communities may benefit from this research through preventive measures to improve farmers' knowledge and awareness regarding strongyloidiasis and leptospirosis and the associated risk factors.


Assuntos
Leptospirose , Strongyloides stercoralis , Animais , Estudos Transversais , Fezes , Humanos , Irã (Geográfico)/epidemiologia , Leptospirose/epidemiologia , População Rural , Estudos Soroepidemiológicos , Estrongiloidíase/epidemiologia
8.
Math Biosci Eng ; 18(4): 3046-3072, 2021 04 02.
Artigo em Inglês | MEDLINE | ID: mdl-34198375

RESUMO

Japanese encephalitis (JE) is a mosquito-borne neglected tropical disease. JE is mostly found in rural areas where people usually keep cattle at home for their needs. Cattle in households reduce JE virus infections since they distract vectors and act as a dead-end host for the virus. However, the presence of cattle introduces risk of leptospirosis infections in humans. Leptospirosis is a bacterial disease that spreads through direct or indirect contact of urine of the infected cattle. Thus, cattle have both positive and negative impacts on human disease burden. This study uses a mathematical model to study the joint dynamics of these two diseases in the presence of cattle and to identify the net impact of cattle on the annual disease burden in JE-prevalent areas. Analysis indicates that the presence of cattle helps to reduce the overall disease burden in JE-prevalent areas. However, this reduction is dominated by the vector's feeding pattern. To the best of our knowledge, this is the first study to examine the joint dynamics of JE and leptospirosis.


Assuntos
Vírus da Encefalite Japonesa (Espécie) , Encefalite Japonesa , Leptospirose , Animais , Bovinos , Efeitos Psicossociais da Doença , Encefalite Japonesa/epidemiologia , Encefalite Japonesa/veterinária , Leptospirose/epidemiologia , Leptospirose/veterinária
9.
Front Cell Infect Microbiol ; 11: 708739, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34277477

RESUMO

Leptospirosis is a neglected zoonosis, caused by pathogenic spirochetes bacteria of the genus Leptospira. The molecular mechanisms of leptospirosis infection are complex, and it is becoming clear that leptospires express several functionally redundant proteins to invade, disseminate, and escape the host's immune response. Here, we describe a novel leptospiral protein encoded by the gene LIC13086 as an outer membrane protein. The recombinant protein LIC13086 can interact with the extracellular matrix component laminin and bind plasminogen, thus possibly participating during the adhesion process and dissemination. Also, by interacting with fibrinogen and plasma fibronectin, the protein LIC13086 probably has an inhibitory effect in the fibrin clot formation during the infection process. The newly characterized protein can also bind molecules of the complement system and the regulator C4BP and, thus, might have a role in the evasion mechanism of Leptospira. Taken together, our results suggest that the protein LIC13086 may have a multifunctional role in leptospiral pathogenesis, participating in host invasion, dissemination, and immune evasion processes.


Assuntos
Leptospira interrogans , Leptospira , Leptospirose , Fibrina/metabolismo , Humanos , Leptospira interrogans/genética , Leptospira interrogans/metabolismo , Plasminogênio/metabolismo , Ligação Proteica
10.
PLoS Negl Trop Dis ; 15(6): e0009410, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34143778

RESUMO

BACKGROUND: Leptospirosis has been described as a biphasic disease consisting of hematogenous dissemination to major organs in the acute phase and asymptomatic renal colonization in the chronic phase. Several observational studies have suggested an association between leptospirosis and chronic kidney disease (CKD). We investigated the dynamics of leptospires and histopathological changes in the kidney to understand the relationship between them, and also investigated the extent of renal dysfunction in the acute and chronic phases of leptospirosis using a hamster model. FINDINGS: Hamsters (n = 68) were subcutaneously infected with 1 × 104 cells of the Leptospira interrogans serovar Manilae strain UP-MMC-SM. A total of 53 infected hamsters developed fatal acute leptospirosis, and the remaining 15 hamsters recovered from the acute phase, 13 of which showed Leptospira colonization in the kidneys in the chronic phase. Five asymptomatic hamsters also had renal colonization in the chronic phase. Immunofluorescence staining showed that leptospires were locally distributed in the renal interstitium in the early acute phase and then spread continuously into the surrounding interstitium. The kidneys of the surviving hamsters in the chronic phase showed patchy lesions of atrophic tubules, a finding of chronic tubulointerstitial nephritis, which were substantially consistent with the distribution of leptospires in the renal interstitium. The degree of atrophic tubules in kidney sections correlated statistically with the serum creatinine level in the chronic phase (rs = 0.78, p = 0.01). CONCLUSION: Subcutaneous infection with pathogenic leptospires could cause acute death or chronic leptospirosis in hamsters after surviving the acute phase. We suggest that the renal distribution of leptospires during the acute phase probably affected the extent of tubular atrophy, leading to CKD.


Assuntos
Rim/microbiologia , Leptospira interrogans , Leptospirose/microbiologia , Insuficiência Renal Crônica/microbiologia , Doença Aguda , Animais , Anticorpos Antibacterianos/sangue , Doença Crônica , Creatinina/sangue , Cricetinae , Leptospirose/complicações , Masculino , Mesocricetus
11.
BMC Vet Res ; 17(1): 221, 2021 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-34154583

RESUMO

BACKGROUND: Leptospirosis is an endemic zoonosis in Brazil, with a great impact on human and animal health. Although dogs are frequently infected by pathogenic Leptospira, the current epidemiological understanding of canine leptospirosis is mainly based on serological tests that predict the infecting serogroup/serovar. Thus, the present study aimed at identifying the causative agent for severe cases of canine leptospirosis in a highly endemic area through the isolation and characterization of the isolated strains. RESULTS: Urine, serum and blood samples were collected from 31 dogs with suspected acute leptospirosis treated at the Veterinary Hospital Service of Santo Amaro University between 2018 and 2019. Acute infection was confirmed in 17 dogs (54.8%) by the associated use of Polymerase Chain Reaction (PCR), Microscopic Agglutination (MAT) and bacteriological culture. Eleven dogs (35.5%) had titers ≥800, with the most frequent serogroups being Autumnalis and Icterohaemorrhagiae (n = 4 each) and Canicola (n = 2). Leptospires were recovered from four dogs, and Multilocus Sequence Analysis (MLSA) revealed infection caused by L. interrogans, which were further characterized as serogroups Canicola (n = 1) and Icterohaemorrhagiae (n = 3). CONCLUSION: The identity of the isolates and serological pattern of MAT suggest that dogs are highly exposed to the serogroup Icterohaemorrhagiae and Canicola, also indicating possible circulation of serogroups not yet isolated in Brazil, notably serogroup Autumnalis. Our findings also reinforce the usefulness of using multiple diagnostic approaches to confirm acute canine leptospirosis.


Assuntos
Doenças do Cão/diagnóstico , Leptospira/isolamento & purificação , Leptospirose/veterinária , Testes de Aglutinação/veterinária , Animais , Brasil , Doenças do Cão/microbiologia , Cães , Leptospira/classificação , Leptospira/genética , Leptospira/imunologia , Leptospira interrogans/isolamento & purificação , Leptospirose/diagnóstico , Leptospirose/microbiologia , Tipagem de Sequências Multilocus/veterinária , Reação em Cadeia da Polimerase/veterinária , Sorogrupo
12.
Med Microbiol Immunol ; 210(4): 211-219, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34164720

RESUMO

The immune response is hypothesized as an important factor in the disease outcome of leptospirosis. Exaggerated immune response may promote tissue damage that lead to severe disease outcome. In this study TNF, IL-10, sTNFR1 levels were measured among sixty-two hospitalized leptospirosis confirmed patients in Sri Lanka. Thirty-one serum samples from healthy individuals were obtained as controls. PCR-RFLP method was used to identify TNF gene polymorphisms and to determine their association with TNF expression and disease severity in leptospirosis. TNF (p = 0.0022) and IL-10 (p < 0.0001) were found to be significantly elevated in leptospirosis patients, while sTNFR1 (p < 0.0001) was significantly suppressed. TNF was not significantly elevated in patients with complications while the anti-inflammatory cytokine IL-10 was significantly elevated among patients with complications (p = 0.0011) and with mortality (p = 0.0088). The ratio of IL-10 to TNF was higher among patients with complications (p = 0.0008) and in fatal cases (p = 0.0179). No association between TNF gene polymorphisms and TNF expression was detected due to the low frequency of heterozygous and mutated genes present in this study population. Thus the findings of the study show that elevated levels of IL-10 in the acute phase of disease could lead to severe outcomes and a high IL-10/TNF ratio is observed in patients with complications due to leptospirosis.


Assuntos
Interleucina-10/sangue , Leptospirose/sangue , Leptospirose/genética , Polimorfismo Genético , Receptores Tipo I de Fatores de Necrose Tumoral/sangue , Fator de Necrose Tumoral alfa/sangue , Fator de Necrose Tumoral alfa/genética , Adulto , Citocinas/sangue , Feminino , Humanos , Interleucina-10/imunologia , Leptospirose/imunologia , Masculino , Pessoa de Meia-Idade , Receptores Tipo I de Fatores de Necrose Tumoral/imunologia , Índice de Gravidade de Doença , Sri Lanka/epidemiologia , Fator de Necrose Tumoral alfa/imunologia
14.
J Vet Intern Med ; 35(4): 1789-1799, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34076314

RESUMO

BACKGROUND: Endothelial dysfunction might contribute to the development of leptospiral pulmonary hemorrhage syndrome (LPHS). HYPOTHESIS: Serum concentrations of markers of endothelial activation and dysfunction are higher in dogs with leptospirosis and correlate with the occurrence of LPHS and a higher case fatality rate. ANIMALS: Clinically healthy dogs (n = 31; 10/31 dogs confirmed healthy based on no detected abnormalities on blood work), dogs with leptospirosis with LPHS (n = 17) and without LPHS (n = 15), dogs with acute kidney injury not due to leptospirosis (AKI-nL, n = 34). METHODS: Observational study. Serum concentrations of soluble intercellular adhesion molecule 1 (sICAM-1), vascular endothelial growth factor (VEGF), and angiopoietin-2 (Ang-2) at admission were compared between groups. Correlations with outcome and the accuracy to predict LPHS were examined. RESULTS: Soluble intercellular adhesion molecule (sICAM-1), VEGF, and Ang-2 concentrations were higher in dogs with AKI-nL (sICAM-1 34.7 ng/mL, interquartile range [IQR] = 24.4-75.5; VEGF 43.1 pg/mL, IQR = 12.3-79.2; Ang-2 8.5 ng/mL, IQR = 6.2-12.3), leptospirosis without LPHS (sICAM-1 45.1 ng/mL, IQR = 30.6-59.0; VEGF 32.4 pg/mL, IQR = 12.5-62.6; Ang-2 9.6 ng/mL, IQR = 6.9-19.3), and LPHS (sICAM-1 69.7 ng/mL, IQR = 42.1-89.1; VEGF 51.8 pg/mL, IQR = 26.3-96.7; Ang-2 8.0 ng/mL, IQR = 5.6-12.2) compared to controls (P < .001). In dogs with leptospirosis, VEGF and sICAM-1 were higher in nonsurvivors (sICAM-1 89.4 ng/mL, IQR = 76.5-101.0; VEGF 117.0 pg/mL, IQR = 90.3-232.4) than survivors (P = .004) and sICAM-1 predicted the development of LPHS. CONCLUSIONS: Soluble intercellular adhesion molecule 1, VEGF, and Ang-2 do not discriminate leptospirosis from AKI-nL. In dogs with leptospirosis, sICAM-1 and VEGF predict outcome and sICAM-1 might identify dogs at risk for LPHS.


Assuntos
Doenças do Cão , Leptospira , Leptospirose , Pneumopatias , Animais , Biomarcadores , Cães , Hemorragia/veterinária , Molécula 1 de Adesão Intercelular , Leptospirose/complicações , Leptospirose/veterinária , Pneumopatias/veterinária , Fator A de Crescimento do Endotélio Vascular
15.
Comp Immunol Microbiol Infect Dis ; 77: 101664, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34091280

RESUMO

Leptospirosis, a zoonotic disease with worldwide distribution, is caused by spirochetes of the genus Leptospira. In dogs, this disease is frequently misdiagnosed. Few studies have attempted to associate the detection of Leptospira spp. infection with clinicopathological and renal histopathological findings using a multidisciplinary approach. The present study isolated and characterized Leptospira spp. obtained from naturally infected dogs and described relevant clinical and histopathological findings. Blood and urine were collected from 57 dogs with clinical symptomatology suggestive of leptospirosis; 38 cases were confirmed by PCR in urine or by culture or microscopic agglutination testing (titers ≥800). A total of 12 strains of pathogenic Leptospira were isolated from the studied dogs (seven in blood, four in urine and one in both blood and urine samples). All isolates were characterized as Leptospira interrogans serogroup Icterohaemorrhagiae. Of the confirmed cases, almost one-third of the animals had been vaccinated. Our analysis of laboratory testing revealed that azotemia and proteinuria were statistically significant predictors of infection. The main histopathological findings seen in kidney tissues were necrosis, degeneration, tubular regeneration, mononuclear inflammatory infiltrate and congestion. A multidisciplinary approach involving clinicopathological and histopathological characterization of renal involvement can aid in the identification of acute leptospirosis infection.


Assuntos
Doenças do Cão , Leptospira interrogans , Leptospira , Leptospirose , Animais , Doenças do Cão/diagnóstico , Cães , Leptospira interrogans/genética , Leptospirose/diagnóstico , Leptospirose/veterinária , Estudos Prospectivos , Sorogrupo
16.
Biomed Res Int ; 2021: 1752904, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34124239

RESUMO

Background: Acute kidney injury (AKI) is one of most prevalent and serious complications of leptospirosis, a prevalent zoonotic disease in tropical countries. Prompt diagnosis of the leptospirosis-associated AKI is a challenge as there are no proper diagnostic tools that can identify patients in the early stage. Kidney injury molecule-1 (KIM-1) and monocyte chemoattractant protein-1 (MCP-1) are widely used novel AKI biomarkers that are studied in various disease conditions with AKI, but not in leptospirosis. Thus, this study is aimed at seeking the importance of KIM-1 and MCP-1 in determining the leptospirosis-associated AKI. Methods: Leptospirosis-suspected patients who were admitted to medical wards of two selected hospitals in the Western province of Sri Lanka were recruited. Leptospirosis was confirmed by three diagnostic tests: PCR, MAT, and culture, and the status of AKI was determined by Kidney Disease Improving Global Outcomes (KDIGO) criteria. Results: Of 170 leptospirosis-suspected patients, 79 were leptospirosis confirmed, and among them, 24.05% of patients were diagnosed to have AKI according to KDIGO criteria. Median serum KIM-1 (p < 0.0001), urine KIM-1 (0.0053), serum MCP-1 (0.0080), and urine MCP-1 (0.0019) levels in those developing AKI were significantly higher than in patients not developing AKI. The biomarker levels associated with leptospirosis AKI had AUC-ROC of 0.8565, 0.7292, 0.7024, and 0.7282 for serum KIM-1, urine KIM-1, serum MCP-1, and urine MCP-1, respectively. Conclusion: This study revealed serum KIM-1 as a promising marker for leptospirosis-associated AKI among the tested biomarkers. Thus, further validation is recommended with a larger study group.


Assuntos
Injúria Renal Aguda , Quimiocina CCL2/sangue , Receptor Celular 1 do Vírus da Hepatite A/sangue , Leptospirose , Injúria Renal Aguda/sangue , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Adulto , Idoso , Biomarcadores/sangue , Feminino , Humanos , Leptospirose/sangue , Leptospirose/complicações , Leptospirose/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sri Lanka
17.
Rev Peru Med Exp Salud Publica ; 38(1): 70-76, 2021.
Artigo em Espanhol, Inglês | MEDLINE | ID: mdl-34190928

RESUMO

Acute Chagas disease (ACD) cases are reported sporadically in Peru. In this report we describe the clinical and epidemiological characteristics of eight new ACD cases detected by the surveillance system in the Amazon basin, between 2009 and 2016. The average age was 12,7 ±13.7 years, range between 1 to 44 years and 4/8 cases were men. One case was associated with acute diarrheal disease, another with Leptospirosis, and two with urinary tract infection. The global case fatality-rate was 12.5% ​​(1/8). Late detection is a frequent characteristic related with low diagnostic suspicion in patients with a history of fever. The TcI and TcIV lineage was identified as the etiological agent of Chagas disease. Eight new cases of ACDs are reported, of which seven were children.


Assuntos
Doença de Chagas , Leptospirose , Trypanosoma cruzi , Adolescente , Adulto , Doença de Chagas/diagnóstico , Doença de Chagas/epidemiologia , Criança , Pré-Escolar , Febre , Humanos , Lactente , Masculino , Peru/epidemiologia , Adulto Jovem
18.
Rev Bras Epidemiol ; 24: e210034, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34105597

RESUMO

OBJECTIVES: This study aimed to describe the incidence and proportional lethality of human leptospirosis in the municipality of São Paulo, between 2007 and 2016, according to sociodemographic factors and characteristics of the disease, and to assess the temporal trends of incidence, according to age group and region of residence. METHODS: Proportional distributions of leptospirosis cases of residents in the municipality were built and regression models with a Binomial Negative response were adjusted. RESULTS: 2,201 cases of leptospirosis were registered, most of them being males (82%), aged between 20 to 59 years (64.6%), white (39%) or brown (32.8%), residing in the South (27.8%), East (23.8%) and North (18.5%) regions. The overall lethality was 15.1%. The risk was higher in the 20 to 59 age group. There was a downward trend in incidence in all age groups and regions, estimated at 5.6% per year. CONCLUSIONS: Despite the downward trend in incidence, leptospirosis is a serious disease with high lethality, affecting mainly male individuals in the age groups considered economically active and living in the peripheral regions of the municipality.


Assuntos
Leptospirose , Adulto , Brasil/epidemiologia , Humanos , Incidência , Leptospirose/epidemiologia , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
BMC Infect Dis ; 21(1): 522, 2021 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-34082705

RESUMO

BACKGROUND: Leptospirosis is a zoonotic spirochetal disease caused by Leptospira interrogans. The clinical presentation ranges from an asymptomatic state to a fatal multiorgan dysfunction. Neurological manifestations including aseptic meningitis, spinal cord and peripheral nerve involvement, cranial neuropathies and cerebellar syndrome are well recognized with varying frequencies among patients with this disease. Posterior reversible encephalopathy syndrome is a very rare occurrence in leptospirosis and only two cases are reported in the medical literature up to now. We report a case of posterior reversible encephalopathy syndrome in a patient with leptospirosis with rhabdomyolysis and acute kidney injury. CASE PRESENTATION: A 21 year-old male presented with fever and oliguric acute kidney injury with rhabdomyolysis. A diagnosis of leptospirosis was made and he was being managed according to the standard practice together with regular hemodialysis. The clinical condition was improving gradually. On day 8 of the illness, he developed headache and sudden painless complete bilateral vision loss followed by several brief generalized tonic clonic seizure attacks. Examination was significant for a Glasgow Coma Scale of 14/15, blood pressure of 150/90 mmHg and complete bilateral blindness. The findings of magnetic resonance imaging of the brain were compatible with posterior reversible encephalopathy syndrome. He was managed with blood pressure control and antiepileptics with supportive measures and standard treatment for leptospirosis and made a complete recovery. CONCLUSION: Posterior reversible encephalopathy syndrome, though very rare with leptospirosis, should be considered as a differential diagnosis in a patient with new onset visual symptoms and seizures, especially during the immune phase. Optimal supportive care together with careful blood pressure control and seizure management would yield a favourable outcome in this reversible entity.


Assuntos
Injúria Renal Aguda/complicações , Leptospirose/complicações , Síndrome da Leucoencefalopatia Posterior/etiologia , Rabdomiólise/complicações , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/fisiopatologia , Injúria Renal Aguda/terapia , Encéfalo/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Leptospirose/diagnóstico , Leptospirose/fisiopatologia , Leptospirose/terapia , Imageamento por Ressonância Magnética , Masculino , Síndrome da Leucoencefalopatia Posterior/diagnóstico , Síndrome da Leucoencefalopatia Posterior/fisiopatologia , Síndrome da Leucoencefalopatia Posterior/terapia , Rabdomiólise/diagnóstico , Rabdomiólise/fisiopatologia , Rabdomiólise/terapia , Resultado do Tratamento , Adulto Jovem
20.
Vet Rec ; 188(9): e143, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33960475

RESUMO

BACKGROUND: Bovine leptospirosis is mainly characterized by reproductive disorders. Contamination of the oocyte was previously demonstrated in vitro, resulting in some apparent damage. However, it is not clear whether it occurs under natural conditions. The present study aimed to characterize the presence of pathogenic Leptospira DNA in the ovarian follicles of non-pregnant cows. METHODS: Follicular fluid samples were collected from 65 animals and subjected to lipL32 PCR and secY sequencing. RESULTS: In total, seven of 65 (10.8%) were positive, indicating a possible early infection of the oocyte. Moreover, secY sequencing identified L. interrogans and L. santarosai, both very closely related to bovine strains from the Sejroe serogroup (Hardjoprjitno and Guaricura). We demonstrated that ovarian follicles can also be infected. CONCLUSIONS: It was hypothesised that ovarian infection can contribute to embryonic death, causing reproductive failure and estrus repetition. In the present study, we show that the organism identified in the follicle is closely related to one that is known to be associated with reproductive disorders.


Assuntos
Doenças dos Bovinos/microbiologia , DNA Bacteriano/isolamento & purificação , Líquido Folicular/microbiologia , Leptospira/genética , Leptospirose/veterinária , Animais , Bovinos , Feminino , Leptospirose/microbiologia , Reação em Cadeia da Polimerase/veterinária , Sorogrupo
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