RÉSUMÉ
Background: Leptospirosis is a widespread re-emerging zoonotic disease, especially in developing countries. According to World Health Organization, despite being severe, the disease is neglected in most endemic countries because of a lack of information and awareness about the extent of the problem. Objective: The objective was to study the seroprevalence and epidemiology of leptospirosis with its biochemical correlation in the general population in Pune, Maharashtra. Materials and Methods: It is a retrospective observational laboratory-based study over 1 year from January to December 2020 in a tertiary care hospital in western India. A total of 561 blood specimens received during 1 year for the diagnosis of fever were processed for Leptospira IgM antibodies using enzyme-linked immunosorbent assay (ELISA). Results: A total of 111 of 561 blood specimens that were received during the study period tested positive for IgM antibody against Leptospira. The seroprevalence of Leptospira spp. was found to be 19.78%. In seropositive patients, the age ranged from 4 to 77 years. The highest seropositivity was observed in the age group of 21–30 years (42%). There were 34% (n = 38) males and 66% (n = 73) females, among those who tested positive. Seroprevalence in Pune was highest in the months of June–August. Renal function tests were deranged in 44 (39.63%) patients (serum creatinine > 1.5 mL). Hyponatremia and hypokalemia were observed in 37.84% and 21.62% of patients, respectively. In liver function tests, serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) both were deranged (SGOT > 40 U/L; SGPT > 56 U/L) in 36 (32.43%) patients, whereas SGOT alone was deranged in additional 18 patients (48.64%). Serum bilirubin was deranged in 65.45%. Coinfection was observed with chikungunya, dengue, and malaria in 7.2%, 6.3%, and 0.90% of patients, respectively. Conclusion: Because morbidity is high in this infection, early diagnosis of leptospirosis is essential because antibiotic therapy provides the greatest benefit when initiated early in the course of illness.
RÉSUMÉ
Introduction: Cryptococcal meningitis is one of the leadingopportunistic infections associated with high mortality. Thepresent study was carried out to determine the prevalence ofcryptococcal antigenemia in HIV-infected patients with CD4+T-cell count ≤ 200 cells/μl.Material and methods: A cross-sectional study includinga total of 100 blood samples of HIV-infected patients withCD4+ T-cell count ≤ 200 cells/μl was carried out in a tertiarycare hospital. The Cryptococcal Antigen Latex AgglutinationTest was performed on serum separated from blood samplesincluded in the study group. A positive cryptococcalantigenemia was diagnosed by positive latex agglutinationtest of cryptococcal polysaccharide antigen in serum. BMI ofall patients included in the study group was calculated andWHO clinical staging of all patients was noted.Results: Three cases out of 100 were positive for cryptococcalantigenemia. The positive cases showed correlation with lowBMI and WHO Clinical stage II and III of HIV disease. Inthe present study, 33.33% and 66.67% of positive cases hadCD4+ T-cell count within the range of 0-100cells/μl and101-200cells/μl respectively.Conclusion: It is important to implement routine screeningfor cryptococcal antigen among HIV-infected cases withCD4+ T-cell count ≤ 200 cells/μl for early detection ofcryptococcal antigenemia. It will help in identifying the riskof subsequent cryptococcal meningitis and initiation of preemptive antifungal treatment.