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2009, Number 3

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

Transition from acute to chronic leptospirosis. Follow-up of seven cases

Velasco-Castrejón Ó, Rivas-Sánchez B, Rivera-Reyes H

Language: Spanish
References: 33
Page: 183-192
PDF size: 113.76 Kb.


ABSTRACT

Contrary to universal popular belief, It is common that the «cured» patients of leptospirosis after they suffer one or more relapses, progressing to chronic phase, in which clinical pictures may occurred other than those observed in the acute phase. Patients and methods: Five women and two men from 21 to 57 years were studied. During the acute phase, antibody search by microscopic agglutination and detection of leptospires by dark field microscopy were performed in each patient; moreover, specific antibiotic therapy was given until recovery. At relapse, a new diagnosis for leptospirosis was performed in each patient. Results: The acute phase of the seven patients was confirmed by the aforementioned methods and they were treated with the antibiotics of choice until cure. Subsequently they relapsed, progressing to chronic phase, but in spite of new treatments using various antibiotics, the disease persisted, so a T leptospirina based on three sero-varieties of heath-died Leptospira interrogans associated to two immunoadjuvant were given. One patient died before it could be implemented, and others evolved towards improvement although to date only two of them can be considered cured. Conclusion: The finding of leptospires in blood and urine and good response to specific treatment for relapse confirm the existence of chronic leptospirosis and difficult to cure.


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