Radiographic chest findings and clinical correlations in leptospirosis.

OBJECTIVE: To determine the clinical presentations, radiographic chest findings, and their correlation in patients with leptospirosis. DESIGN: A cross sectional study. SETTING: Between July 2001- December 2002 at 3 hospitals in North Eastern Thailand. MATERIAL AND METHOD: Two hundred and forty patients with laboratory confirmed leptospirosis. RESULTS: Two hundred and nine (87.1%) patients were males. The mean age was 37.53 years (range 13-76). The median duration of fever was 3 days (range 1-13). Overall, 154 patients (64.2%) had respiratory symptoms and 26 (10.8%) patients had hemoptysis. Jaundice was detected in 76 (31.7%) patients, hypotension in 50 (20.8%), renal dysfunction in 80 (30%), and multiorgan dysfunction in 62 (25.8%) on admission. One hundred and fifty-four (64.17%) patients had abnormal chest radiographs on admission (classified as cardiovascular, pulmonary, and mixed cardio-pulmonary involvement in 40 (25.97%), 41 (26.62%), and 73 (47.4%) patients, respectively). Jaundice was significantly associated with the likelihood of having abnormal chest radiography on admission. Air- space nodules detected on the chest radiograph were significantly more common in patients with renal dysfunction and patients who required mechanical ventilation. CONCLUSION: Pulmonary and cardiovascular involvements are common in leptospirosis. Air-space nodules detected by chest radiography may indicate severe leptospirosis.

Intestinal parasitic infections in Thai patients: Five-year experiences at Siriraj Hospital.

Objective: To determine the prevalence of intestinal parasitic infections at Siriraj Hospital Methods: 4,206 non-repeat stool samples (817 from HIV infected patients, and 3,389 from non-HIV infected patients) were submitted for coproparasitological examination between August 2000 and July 2005. All stool specimens were examined for ova and parasites, using simple wet-preparation and formal-ether concentration. Modified Ziehl-Neelson, and modified Trichrome-blue staining were tested routinely only in HIV infected patients. Results: Intestinal parasites were detected in 18.9 % (41% in HIV infected group and 13.6% in non-HIV infected group respectively). S. stercoralis was the most prevalent intestinal parasite found in both groups (6.5 % in HIV infected and 5% in non-HIV infected group). The prevalence of C. parvum infection and microsporidial infection were 20.7% and 15.5% in the HIV infected group respectively. Conclusion: Intestinal parasitic infections remain an important problem in Thailand.