Atypical Presentation of Typical Carcinoid of Lung with Therapeutic Cryoextraction –A Case Report

ABSTRACT

Introduction: Leptospirosis is a widespread zoonosis causedby the spirochete leptospira. Epidemic leptospirosis is beingreported from Kerala during the monsoon. Its incidence hasincreased over the past two decades. Severe leptospirosisresults in sepsis with multi organ dysfunction syndrome andmortality rate varies from 5-40%. In this study we attemptedto identify the risk factors associated with mortality ofleptospirosis.Material and methods: This was a retrospective case-controlstudy among patients diagnosed with severe leptospirosisand admitted in a tertiary care hospital in Thrissur District ofKerala during the monsoon of 2014. Data was collected fromcase records of 48 patients out of which 21 were cases (nonsurvivors) and 27 were controls (survivors) and Statisticalanalysis was done using X2 test with Epi info software.Results: Mean age of study population was 42 yrs. There were38 male (79%) out of which 14 were cases and 10 females(21%) out of which 7 were cases. Mortality rate was 44%. 77%of them presented with myalgia. Among cases 62% had icterus,81% had oliguria, 66% underwent mechanical ventilationand 62% undergone blood and blood product transfusion.Dyspnoea (p=0.08), Chest crepitations (p=0.005), decreasedurine output(p=0.012), acute kidney injury(p=0.005), hepaticdysfunction(p=0.06), shock (p=0.019), haemoglobin less than10g% (p=0.03) and platelet count less than 20000(p=0.025)were found to have significant association with mortality.Conclusion: The severe disease is more common in middleaged males but mortality is more in female. Platelet countless than 20000 and shock were found to be the independentpredictors of mortality.