ABSTRACT
Introducción: El síndrome de Weil es una forma grave de la infección bacteriana causada por la bacteria Leptospira, conocida como leptospirosis. Este se caracteriza por la disfunción de múltiples órganos, entre ellos, hígado, riñón, músculos, serosas o el sistema neurológico, en este caso denominado neuroleptospirosis, genera una mortalidad muy elevada cuando no se brinda diagnóstico y tratamiento adecuado. Objetivo: Describir las manifestaciones clínicas, paraclínicos complementarios y tratamiento de un paciente con síndrome de Weil, una condición poco frecuente. Caso clínico: Paciente de 23 años quien consulta en el contexto de síndrome febril agudo asociado con neuritis óptica, dolor torácico y paraclínicos que evidenciaron afectación hepática y cardíaca. Se confirma el diagnóstico de síndrome de Weil dado por neuroleptospirosis, pericarditis y colestasis intrahepática. Conclusiones: mediante un caso clínico de síndrome de Weil, se describe la afectación multisistémica de complicaciones asociadas con leptospirosis, con manifestaciones poco habituales como neuroleptospirosis, pericarditis y colestasis intrahepática(AU)
Introduction: Weil syndrome is a serious form of the bacterial infection caused by the Leptospira bacterium; this is known as leptospirosis. This is characterized by multiple organ dysfunction; for example, the liver, kidney, muscles, of serous type, or the neurological system, in this case called neuroleptospirosis, which produces a very high mortality when adequate diagnosis and treatment are not provided. Objective: To describe the clinical manifestations, complementary paraclinic practice and treatment of a patient with Weil syndrome, as a rare condition. Clinical case: 23-year-old patient who presents with acute febrile syndrome associated with optic neuritis, chest pain, and paraclinical symptoms obviously consistent liver and cardiac involvement. The diagnosis of Weil syndrome is confirmed, specifically defined by neuroleptospirosis, pericarditis, and intrahepatic cholestasis. Conclusions: Through a clinical case of Weil syndrome, the multisystem involvement of complications associated with leptospirosis is described, along with its unusual manifestations, such as neuroleptospirosis, pericarditis, and intrahepatic cholestasis(AU)
Subject(s)
Humans , Male , Female , Weil Disease/epidemiology , Leptospirosis/drug therapy , Leptospirosis/epidemiology , Multiple Organ Failure/diagnosisABSTRACT
Se realizaron en este estudio encuestas epidemiológicas a 59 pacientes con leptospirosis, diagnosticada entre los años 1996 al 98 para conocer el comportamiento de la enfermedad en el municipio de San Luis, Pinar del Río. Se analizaron los siguientes datos: edad, sexo, meses de mayor incidencia, distribución geográfica y dónde y cómo adquirió la enfermedad. Estos datos se procesaron mediante calculadoras personales y fueron expresados en tablas y porcentajes. Se demostró que ocurrió un brote en 1997, con 33 casos para el 56 (por ciento). El grupo de edad más afectado fue de 15 a 29 años con 30 casos para el 50,8 (por ciento). El sexo masculino aportó el mayor número de casos, lo que está muy relacionado con las labores agrícolas. Los meses de mayor incidencia fueron octubre y noviembre con 19 y 28 casos respectivamente. La zona más afectada fue la rural con 46 casos, para el 78 (por ciento). El mayor número de pacientes adquirió la enfermedad por vía indirecta(AU)
Epidemiological surveys were done as part of this study among 59 patients with leptospirosis diagnosed betweeen 1996 and 1998 to know the behavior of the disease in the municipality of San Luis, Pinar del Río. The following data were analyzed: age, sex, months of higher incidence, geographical distribution and where and how the disease was caught. These data were processed by personal calculators and expressed in tables and percentages. There was an outbreak in 1997 with 33 cases, accounting for 56 percent. The 15-29 age group was the most affected with 30 cases, for 50.8 percent. The fact that most of the cases were males was closely related to the agricultural work. The highest incidence was observed during October and November with 19 and 28, respectively. The rural area was the most affected with 46 cases, for 78 %. Most of the patients got the disease by indirect way(AU)
Subject(s)
Humans , Male , Female , Adult , Weil Disease/epidemiology , Communicable Disease Control/methods , Disease Outbreaks , Health Surveys/methods , Longitudinal Studies , Leptospirosis/epidemiology , Prospective StudiesABSTRACT
A serologic survey was carried out on slum dwellers in the city of Rio de Janeiro. A total of 259 serum samples from male and female individuals of different age groups were tested for the presence of antileptospire antibodies by microagglutination. Prevalence data were analyzed in relation to the major risk factors present at the site, mainly represented by the presence of carrier animals and the occurence of frequent floods. Of the samples tested, 25% reacted with antigens of different serogroups at titres ranging from 1:100 to 1:6400, with a predominance of titres <= 1:400; 35% of positive sera reacted with leptospirae of the Icterohaemorrhagiae serogroup. Reactions with Djasiman, Panama, Javanica, Canicola, Pyrogenes, Australis, Ballum, Sejroe, Bataviae, Grippotyphosa, Autumnalis and Cynopteri were also detected, though at lower frequencies. There was no statistically significant difference between sexes, but higher prevalence rates were found to be associated with increasing age. A focus of infection was characterized, in which social and economic factors contribute to the persistance of leptospirae by favoring the proliferation of the main reservoir
Subject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Antibodies, Bacterial , Leptospira/immunology , Leptospirosis/epidemiology , Brazil , Leptospira interrogans/immunology , Poverty Areas , Swine , Weil Disease/epidemiologyABSTRACT
Although human cases of leptospirosis have been reported from the Philippines, there is a lack of data on its prevalence. We therefore surveyed three rice-farming villages for the presence of leptospiral antibody. Out of 155 sera tested, 63 (43.6%) tested positive using the standard microagglutination test. Antibodies were more frequent in men than women (48 vs. 31%, respectively, p less than 0.01), and less common in the elderly. Exposure to leptospires occurs frequently in rice farmers, and leptospirosis is likely to be an underdiagnosed cause of both mild and severe febrile illness in the Philippines.
Subject(s)
Adolescent , Adult , Aged , Agricultural Workers' Diseases/epidemiology , Antibodies, Bacterial/analysis , Female , Humans , Leptospira interrogans/immunology , Male , Middle Aged , Oryza , Philippines , Weil Disease/epidemiologyABSTRACT
Se presentan los dos últimos casos de leptospirosis registrados en el Estado de Yucatán. Ambos casos cursaron con el cuadro clínico correspondiente a la forma ictérica grave o "Síndrome de Weil". Uno de ellos presentó compromiso pulmonar intenso y falleció. Los títulos máximos de reactividad serológica fueron de 1:800 y 1:1600 en uno y otro paciente respectivamente y en ambos contra el serotipo icterohaemorragiae. En la biopsia de hígado del paciente muerto se observó leptospiras. Se hace una revisión clínica y epidemiológica de los casos diagnosticados hasta ahora en la región y se insiste sobre la necesidad de incluirla en el diagnóstico diferencial de otros procesos infecciosos, para tener un mejor conocimiento de su importancia epidemiológica en México
Subject(s)
Adolescent , Aged , Humans , Male , Female , Weil Disease/epidemiology , Weil Disease/pathology , MexicoABSTRACT
De 1§ de abril a 31 de dezembro de 1979, foi realizado um estudo caso-controle com pacientes com leptospirose internados no Hospital Couto Maia e residentes em Salvador, visando análisar os aspectos sócio-econômicos desta infecçäo. Após confirmaçäo laboratorial do diagnóstico clínico de leptospirose, através da reaçäo de soroaglutinaçäo microscópica com o antigeno Patoc I, os pacientes eram pareados de acordo com o sexo, idade e data de nascimento, com outros pacientes, do mesmo hospital, com diagnóstico diferente de leptospirose e hepatite, também residentes em Salvador. Os dados foram obtidos através de questionário aplicado aos pacientes ou familiares e de observaçäo direta do local de residência. Foram estudados 41 casos de leptospirose, e seus respectivos controles. 72,7% dos pacientes com leptospirose estudados pertencia ao sexo masculino e se encontrava na faixa etária de 20 a 60 anos. Os pacientes estudados, casos e controles distribuíam se por toda a área de Salvador, residindo, principalmente, em bairros populares como Liberdade, Säo Caetano, Federaçäo etc. A naturalidade de 48,8% dos pacientes, casos e controles, foi do Microrregiäo de Salvador, no Estado da Bahia. Em relaçäo ao grau de instruçäo, 21,9% dos casos e 17,1% dos controles era analfabeto e 48,8% dos casos e 43,9% dos controles possuía instruçäo primária. Pacientes com leptospirose e controles exercem, na sua maioria ocupaçöes de baixa e média qualificaçäo. A renda média, frequentemente, foi igual ou inferior a um salário mínimo, muitas vezes os pacientes näo possuem renda fixa. A média do índice de aglomeraçäo foi de 2,5 pessoas/cômodo, nos casos, e 2,4 pessoas/cômodo, nos controles. O tempo de permanência no domicílio, encontrado com maior frequência em casos e controles, foi de mais de 10 anos e de 1 ano. O motivo mais frequente de mudança foi o aumento do aluguel...