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Volume 16, Number 2—February 2010
Dispatch

Severe Leptospirosis in Hospitalized Patients, Guadeloupe

Cécile Herrmann-StorckComments to Author , Magalie Saint Louis, Tania Foucand, Isabelle Lamaury, Jacqueline Deloumeaux, Guy Baranton, Maurice Simonetti, Natacha Sertour, Muriel Nicolas, Jacques Salin, and Muriel Cornet
Author affiliations: Guyane University, Guadeloupe, French West Indies (C. Herrman-Storck, M. Saint Louis, T. Foucand, I. Lamaury, J. Deloumeaux, M. Simonetti, M. Nicholas, J. Salin); Institut Pasteur, Paris, France (G. Baranton, N. Serour, M. Cornet); and Paris Descartes University, Paris (M. Cornet)

Main Article

Table 1

Demographic, epidemiologic, and clinical characteristics as a function of severity among 168 case-patients with confirmed leptospirosis, Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies, 2003–2004*

Characteristics
Univariate analysis†

Multivariate analysis
All case-patients, 
N = 168
Case-patients with severe disease, n = 24
Case-patients 
with nonsevere disease, n = 144
p value
OR (95% CI)
p value
Male sex 143/168 (85.1) 18/24 (75) 125/144 (86.8) 0.2 2.6 (0.4–17.7) 0.3
Age, y, mean ± SD (no. patients)
F 58.5 ± 17.9 (25) 55.5 ± 2.4 (6) 36.7 ± 8 (19) 0.05
M
47 ± 15.9 (143)
51.8 ± 6.5 (18)
49.6 ± 2.9 (125)
0.5



Exposure to occupational risk‡ 74/133 (55.6) 12/20 (60) 62 /113 (54.8) 0.6
Contact with swine 41/115 (35.6) 5/10 (50) 36/105 (34.2) 0.5
Contact with cattle 36/113 (31.9) 1/10 (10) 35/103 (34) 0.8
Contact with rodents
56/114 (49.1)
3/9 (33.3)
53/105 (50.5)
0.5



Medical history
Duration of illness before 
 antibacterial therapy§ >10 d 21/141 (14.9) 7/22 (31.8) 14/119 (11.8) 0.01 4.8 (1.1–20.2) 0.032
Diabetes mellitus 13/75 (17.3) 3/22 (13.6) 10/53 (18.9) 0.5
Chronic hypertension ¶ 24/75 (32) 9/22 (40.9) 15/53 (28.3) 0.2 30.9 (6.0–157.4) <0.001
Chronic alcoholism#
29/75 (38.7)
11/22 (50.0)
18/53 (34)
0.2

16.8 (4.1–57.9)
<0.001
Initial features
Hypothermia (<36.5°C) 28/144 (19.4) 7/23 (30.4) 21/121 (17.3) 0.1 4.6 (0.9–24.6) 0.07
Hyperthermia (>37.7°C) 82/144 (56.9) 10/23 (43.5) 72/121 (59.5) 0.1 3.8 (0.7–21.2) 0.12
Hypotension, SBP <100 mm Hg 24/143 (16.8) 7/20 (35) 17/123 (13.8) 0.02 0.3 (0.1–1.8) 0.2
Myalgia 73/77 (94.8) 12/13 (92.3) 61/64 (95.3) 0.6
Consciousness disorders 10/119 (8.4) 4/13 (30.8) 6/106 (5.7) 0.01 3.8 (1.1–13.2) 0.035
Nuchal rigidity 10/116 (8.6) 2/12 (16.7) 8/104 (7.7) 0.2
Headache 70/91 (76.9) 5/7 (71.4) 65/84 (77.4) 0.7
Conjunctival suffusion 46/116 (39.6) 4/12 (33.3) 42/104 (40.4) 0.4
Icterus 57/117 (48.7) 9/12 (75) 48/105 (45.7) 0.1 5.9 (1.1–31.1) 0.036
Hemorrhage** 15/165 (9.1) 5/24 (20.8) 10/141 (7.1) 0.04 4.2 (0.3–67.9) 0.31
Hepatosplenomegaly 30/86 (34.9) 7/11 (63.6) 23/75 (30.7) 0.02 1.7 (0.2–13.9) 0.62
Abdominal pain 64/124 (51.6) 14/18 (77.8) 50/106 (47.2) 0.009 3 (0.7–13.2) 0.139
Digestive disorders (diarrhea, 
 vomiting) 66/105 (62.8) 12/15 (80) 54/90 (60) 0.2 3.5 (0.7–18.0) 0.12
Abnormalities at chest 
 auscultation†† 19/135 (14.1) 8/17 (47) 11/118 (9.3) <0.001 8.7 (1.8–41.3) 0.006
Chest radiologic anomalies‡‡ 22/112 (19.6) 6/16 (37.5) 16/96 (16.7) 0.05 0.8 (0.1–10.4) 0.85
Alveolar infiltrate 9/112 (8.0) 5/16 (31.2) 4/96 (4.2) <0.001
Electrocardiographic disorders§§ 22/73 (30.1) 5/16 (31.2) 17/57 (29.8) 0.9
Oliguria¶¶ or anuria 34/128 (26.6) 10/23 (43.5) 24/105 (22.9) 0.04 5.6 (1.5–20.6) 0.009

*OR, odds ratio; CI, confidence interval; SBP, systolic blood pressure. Boldface indicates significance.
†All values no. case-patients/no. examined (%) except as indicated.
‡Farming, livestock farming, construction, and gardening.
§Ampicillin or cefotaxime.
¶As reported by patients with specific therapy.
#Defined as alcohol dependence.
**Hemoptysis, hematuria, purpura, bleeding of the gums, and hematemesis.
††Crackles or ronchi.
‡‡Only anomalies of the lungs.
§§Excluding patients >60 y of age or with sinus tachycardia.
¶¶Urinary volume <400 mL/d.

Main Article

Page created: December 10, 2010
Page updated: December 10, 2010
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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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