Leptospirosis in Barbados: a clinical study

ABSTRACT

A 39-month clinical study of leptospirosis was undertaken at the Queen Elizabeth Hospital, Barbados. Eighty-eight patients had a confirmed diagnosis of the disease during the period. The major serogroups identified were autumnalis (including a new serovar bim), icterohaemorrhagiae, ballum and canicola. The majority of patients presented with jaundice (95 percent), anorexia and headaches (85 percent), fever (76 percent) and conjunctival suffusion (54 percent). While abnormal creatinine levels were seen in 49 percent of patients on admission, only 16 percent were judged to have renal failure. The urine to plasma urea ratio showed high sensitivity and specificity in the diagnosis of pre-renal azotemia. Cardiac arrthymias and myocarditis occurred in 18 percent of patients and pericarditis in 6 percent. An elevated serum amylase was found in 65 percent of cases. The bilirubin level took 5.5 weeks to return to normal. Thrombocytopenia was shown not to be due to a disseminated intravascular coagulation, and a randomised trial dose penicillin did not reveal any benefit to jaundiced patients. The overall mortality during the study was 5.7 percent (AU)