Clinical Features And Outcome Of Leptospirosis

Abstract

Background: Leptospirosis is a common zoonotic infection with varied clinical presentation and significant morbidity and mortality, especially in tropical regions. Early identification of severe disease remains a challenge in clinical practice.

Aim: To study the clinical features and outcome of leptospirosis in adults with special reference to serum procalcitonin.

Materials and Methods: A prospective observational study was conducted in adult IPD patients in the Department of Medicine for a duration of one year. A total of 70 cases were included in the study.

Results: A total of 70 patients aged between 16–79 years were included, of which 48.6% were males and 51.4% were females. Majority of patients (60.0%) belonged to the <40 years age group. Common presenting features included altered sensorium (60.0%), abdominal pain (20.0%), vomiting (15.7%), jaundice (17.1%), dyspnea (17.1%), seizure (17.1%) and headache (10.0%). 95.7% patients were discharged successfully, while 4.3% patients expired. A statistically significant association was found between serum procalcitonin levels and outcome (p=0.023). Patients with higher procalcitonin levels showed more severe biochemical derangements and elevated inflammatory markers. No significant association was observed between outcome and other parameters such as ALP, ferritin, LDH, creatinine, CRP, urea, age, and duration of fever.

Conclusion: Leptospirosis has a varied clinical presentation with frequent multisystem involvement. Serum procalcitonin is a useful prognostic marker and is significantly associated with clinical outcome. Higher procalcitonin levels are associated with increased disease severity and adverse outcomes. Early measurement of procalcitonin may help in identifying high-risk patients and guiding clinical management, although larger studies are required for further validation.