medigraphic.com
ISSN 0185-6014 (Print)
Órgano oficial de difusión de la Federación Mexicana de Patología Clínica, AC y de la Asociación Latinoamericana de Patología Clínica/Medicina de Laboratorio

2009, Number 3

Next >>

Rev Mex Patol Clin Med Lab 2009; 56 (3)

Chronic leptospirosis in Mexico: microscopic diagnosis and evidence supporting its existence and importance

Velasco-Castrejón O, Rivas-Sánchez B, Sánchez-Spíndola ME, Soriano J, Rivera-Reyes HH, Garibay SV

Language: Spanish
References: 35
Page: 157-167
PDF size: 143.18 Kb.


ABSTRACT

Chronic leptospirosis is a common clinical form but little-known and simulator of multiple diseases, which makes patients peregrinates from physician to physician and even tend to die without accurate diagnosis. Material and methods: We studied 374 patients of both sexes, 1 to 86 years, clinically diagnosed with chronic leptospirosis for more than 6 months of evolution. Serology was performed by MAT. The leptospires were detected by dark field videorecording, silver impregnation and immunodetection in blood and urine. A 10 electron microscopy was performed in blood and in another 10, who died, the leptospires were searched in various organs by silver staining and immunodetection techniques. Results: 75.7% of patients had low titers (‹ 1:80). Leptospires was observed in 85% and 89.9% by dark field videorecording, in 75% and 77% by silver staining and by 77% and 85% by immunodetection in blood and urine. Furthermore electron micrographs were obtained in 3 cases. Although 82% of cultures were early positive only we could get 3 strains. This strains were typify as Leptospira Pomona. Furthermore leptospires were observed in 87% of the tissue of deceased individuals. Discussion: These results, particularly those obtained by necropsy, ultramicroscopy and culture, associated with the long evolution of clinical, sometimes several years, confirm the existence of chronic leptospirosis and its importance as a cause of death. This report demonstrates too the high diagnostic value of dark field videorecording.


REFERENCES

  1. Barthi AR, Jarlath EN, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, Levett PN, Gilmant RH, Willing MR, Gotuzzo E, Vinetz JM, Peru. USA Leptospirosis Consortion. Lancet Infect Dis 2003; 3 (12).

  2. Faine S. Guidelines for the control of Leptospirosis. Geneve: WHO; 1982.

  3. Ellis WA. The diagnosis of leptospirosis in farm animals. In: Ellis WA (eds). The present state of leptospirosis diagnosis and control. Dordrecht, The Netherlands: Martinus Nijhoff; 1986. p. 13-31.

  4. Ellis WA. OIE, Office International des Epizooties. 2000. Manual of Standards for Diagnostic test and vaccines. Paris.

  5. Levett PN. Leptospirosis. Clin Microbiol Rev 2001; 14 (2): 296-326.

  6. Murgatroyd F. Chronic meningitis in Weil´s disease. Br Med J 1937: 711.

  7. Nicolescu M, Andrescu N. May human leptospirosis develop as a chronic infection? Zentralbl Bakteriol Mikrobiol Htg 1984; 257: 531-534.

  8. Rathinam SR. Ocular manifestations of leptospirosis. JPGM 2005; 51: 189-194.

  9. Tripathy DN, Hanson LE. Some observations on chronic leptospiral carrier state in gerbils experimentally infected with Leptospira grippotyphosa. J Wildl Dis 1976; 12: 55-58.

  10. Leptospirosis Information Center. Persistant Human Leptopsirosis (update August 2001). Disponible en: http://www. leptospirosis.org

  11. Avdeeva MG. Outcome and tendency of late convalescence in icterohemorrhagic leptospirosis. Klin Med (Mosk) 2003; 81 (6): 42-47.

  12. Mel´ink GV, Degtiar´LD. Renal involvement in convalescents after icterohaemorrhagic leptospirosis. Klin Med (Mosk) 2000; 78 (12): 40-43.

  13. Shpilberg O, Shaked Y, Maier MK, Samra D, Samra Y. Longterm follow-up after leptospirosis. South Medical J 1990; 83 (4): 405-407.

  14. Velasco-Castrejón O, Rivas-Sánchez B, Gutierrez E, Chávez L, Duarte P, Chavarría S, Rivera-Reyes HH. Leptospira: ¿simulador o causante de leucemia? Rev Cub Med Trop 2005; 57: 17-24.

  15. Velasco-Castrejón O, Rivas-Sánchez B., Rivera-Reyes HH. Leptospirosis humana crónica. En: Narro-Robles SO, López BJJ (eds). Diagnóstico y Tratamiento en la Práctica Médica. 3a ed. México: Manual Moderno; 2008.

  16. Velasco-Castrejón O, Rivas-Sánchez B. Enfermedades simuladas y acompañantes de leptospirosis. Rev Cub Med Trop 2005. 57:75-76.

  17. Velasco-Castrejón O. Seguimiento de casos de leptospirosis. En: Importancia de la leptospirosis como una zoonosis emergente en México. México: Coordinación de Vigilancia Epidemiológica, SSA; 1998.

  18. WHO/ILS. Human Leptospirosis. Guidance for diagnosis survellaince and control. WHO-ILS; 2002.

  19. Frenkel JK. La inmunidad en la toxoplasmosis. Bol Sanit Panam 1986; 100.

  20. Centro Panamericano de Zoonosis. Procedimientos para estudio de prevalencia de enfermedades crónicas en el ganado. OPS-OMS. Nota técnica No. 18. 1993.

  21. Munday BL, Corbould. Leptospira pomona Infections in wombats. J Wildlife Dis 1973; 9: 72-73.

  22. Trevejo RT, Rigau PJG, Ashford DA, McClure EM, Jarquin GC, Amador JJ, de los Reyes JO, Gonzalez A, Kaki SR, Shieh WJ, Mc Lean RG, Nasci RS, Bolin CA, Braga SL, Perkins BA, Spiegel RA. Epidemic leptospirosis associated with pulmonary hemorrhage-Nicaragua 1995. J Infect Dis 1998; 178: 1457-1463.

  23. Chandrasekaran S, Gomathi S. A standard screening test for the early and rapid diagnosis of leptospirosis. Indian J Medical Microbiol 2004; 22 (1): 23-27.

  24. Anderson JF, Miller AD, Post J, Johnson RC, Magnarelli LA, Andreades TG. Isolation of Leptospira interrogans from the skin of a dog. JAMVA 1993; 203: 1550-1551.

  25. Tappero JW, Sanders EJ, Ashford DA, Perkins BA, Shutt KA, Leake JA, Bragg SL, Spiegel RA, Rigau-Perez JG, Bruce MG, Zaidel O, Aye T, Deseda CC. Leptospirosis among patients presenting with dengue-like illness in Puerto Rico. Acta Tropica 2005; 96 (1): 36-46.

  26. Velasco-Castrejón O, Rivas-Sánchez B, Becker I, Velasco CA. VECOVISION, un nuevo método imagenológico para el diagnóstico definitivo de leptospirosis. Rev Cub Med Trop 2002; 54: 67.

  27. Bartholomew JW. Stains for microorganisms in smears. In: Clark George (ed). Staining Procedures. 4th ed. Baltimore, Maryland: Williams & Wilkins; 1981. p. 409-410.

  28. Hartskeerl RA, Smits HL, Korver H, Goris MGA, Terpstra WJ, Fernández C, Obregón AM, Rodríguez I, Zamora Y, Rodríguez N, Rodríguez JE, Martinez MB. International course of laboratory methods for diagnosis of leptospirosis. II Taller Internacional de Leptospirosis, La Habana, Cuba.

  29. Javois Lorette C. Immunocytochemical methods and protocols 115. 2nd ed. Totowa, NJ: Human Press; 1999.

  30. Schollum LM, Blackmore DK. Leptospirosis of pigs farms. The results of a serological survey. NZ Med J 1982; 12 (95): 299-301.

  31. Kingscote BF. Leptospirosis: An occupational hazard to veterinarians. Can Vet J 1986; 27: 78-81.

  32. McDonough. Leptospirosis in dogs – current status. In: International Veterinary Information Service (www.ivis.org) L Carmichael (ed). Ithaca, New York, USA. 2001.

  33. Biosecurity Australia. A scientific review of leptospirosis and implications for quarantine policy. Australia: Department of Agriculture, Fisheries & Forestry; 2000.

  34. Srivastava SK, Gupta BR, Harbola PC. Humoral immune response in Leptospira infected experimental goats. Ind J Anim Sci 1989; 59: 1213-1216.

  35. Morales GA, Guzmán VH, Beltrán LE. Leptospirosis in Colombia: Isolation of Leptopsira spp from the kidneys of brown rats (Rattus novergicus) trapped on infected piggeries. Trop An Health Prod 1978; 10: 121-123.




2020     |     www.medigraphic.com