Sequel and therapeutic modalities of leptospirosis associated severe pulmonary haemorrhagic syndrome (SPHS); a Sri Lankan experience.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968551 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2334 (Electronic) Linking ISSN: 14712334 NLM ISO Abbreviation: BMC Infect. Dis. Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
    • Abstract:
      Background: The emergence of leptospirosis-associated severe pulmonary hemorrhagic syndrome (SPHS) with high case fatality has been reported from many countries. Understanding of clinical disease and sequel of SPHS needs larger studies with adequate numbers. The purpose of this study was to describe the characteristics and sequel by different therapeutic approaches for SPHS in Leptospirosis in Sri Lanka.
      Methods: This study was conducted at Teaching Hospital-Karapitiya (THK), Galle, Sri Lanka from June 2015 to December 2017. THK is the main tertiary care center for the Southern Province. All confirmed-cases of leptospirosis who presented during this period and were admitted to five medical units of THK were included in this study. SPHS was defined as a patient presenting; haemoptysis, arterial hypoxemia (Acute Lung Injury Score < 2.5), haemoglobin drop (10% from the previous value), or diffused alveolar shadows in the chest radiograph, without alternative explanation other than leptospirosis.
      Results: Of the 128 MAT confirmed cases of leptospirosis, 111 (86.7%) had acute kidney injury (AKI) whilst SPHS was seen in 80 (62.5%). Patients typically developed SPHS within the first week of illness, mostly on days 4 and 5. The case fatality rate of this study sample was 28.1% (n = 36), while for patients with SPHS, it was 41.5%. Most of the deaths (n = 19) were within the first 3 days of admission (on the same day 8, and within next 48 h 11). Among SPHS patients, 59 received therapeutic plasma exchange (TPE). The survival rate was higher (n = 35, 74.5%) when the TPE was performed within the first 48 h of detecting SPHS compared to patients in whom the procedure was done after 48 h (n = 5, 54.5%). Of the 19 leptosprosis patients with SPHS who did not receive TPE, 17 died (89.5%). However, the group of patients who received TPE was primarily the patients survived beyond day 3.
      Conclusions: We observed that during the study period, SPHS was common and the mortality rate was higher in the study area. The treatment modalities tested need further evaluation and confirmation.
    • Grant Information:
      U19 AI115658 United States AI NIAID NIH HHS
    • Contributed Indexing:
      Keywords: Galle; Leptospirosis; Severe pulmonary hemorrhagic syndrome; Sri Lanka; Therapeutic plasma exchange
    • Accession Number:
      0 (Immunoglobulins)
    • Publication Date:
      Date Created: 20190523 Date Completed: 20190722 Latest Revision: 20190722
    • Publication Date:
      20190723
    • Accession Number:
      10.1186/s12879-019-4094-0
    • Accession Number:
      31113404
  • Citations
    • ABNT:
      HERATH, N. et al. Sequel and therapeutic modalities of leptospirosis associated severe pulmonary haemorrhagic syndrome (SPHS); a Sri Lankan experience. BMC Infectious Diseases, [s. l.], v. 19, n. 1, p. 451, 2019. DOI 10.1186/s12879-019-4094-0. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=31113404. Acesso em: 18 jan. 2020.
    • AMA:
      Herath N, Uluwattage W, Weliwitiya T, et al. Sequel and therapeutic modalities of leptospirosis associated severe pulmonary haemorrhagic syndrome (SPHS); a Sri Lankan experience. BMC Infectious Diseases. 2019;19(1):451. doi:10.1186/s12879-019-4094-0.
    • APA:
      Herath, N., Uluwattage, W., Weliwitiya, T., Karunanayake, L., Lekamwasam, S., Ratnatunga, N., … Agampodi, S. (2019). Sequel and therapeutic modalities of leptospirosis associated severe pulmonary haemorrhagic syndrome (SPHS); a Sri Lankan experience. BMC Infectious Diseases, 19(1), 451. https://doi.org/10.1186/s12879-019-4094-0
    • Chicago/Turabian: Author-Date:
      Herath, Nalaka, Wimalasiri Uluwattage, Theshanthi Weliwitiya, Lilani Karunanayake, Sarath Lekamwasam, Neelakanthi Ratnatunga, Panduka Karunanayake, et al. 2019. “Sequel and Therapeutic Modalities of Leptospirosis Associated Severe Pulmonary Haemorrhagic Syndrome (SPHS); a Sri Lankan Experience.” BMC Infectious Diseases 19 (1): 451. doi:10.1186/s12879-019-4094-0.
    • Harvard:
      Herath, N. et al. (2019) ‘Sequel and therapeutic modalities of leptospirosis associated severe pulmonary haemorrhagic syndrome (SPHS); a Sri Lankan experience’, BMC Infectious Diseases, 19(1), p. 451. doi: 10.1186/s12879-019-4094-0.
    • Harvard: Australian:
      Herath, N, Uluwattage, W, Weliwitiya, T, Karunanayake, L, Lekamwasam, S, Ratnatunga, N, Karunanayake, P, Wickramasinghe, S, Patabendi, S, Senaviratne, S & Agampodi, S 2019, ‘Sequel and therapeutic modalities of leptospirosis associated severe pulmonary haemorrhagic syndrome (SPHS); a Sri Lankan experience’, BMC Infectious Diseases, vol. 19, no. 1, p. 451, viewed 18 January 2020, .
    • MLA:
      Herath, Nalaka, et al. “Sequel and Therapeutic Modalities of Leptospirosis Associated Severe Pulmonary Haemorrhagic Syndrome (SPHS); a Sri Lankan Experience.” BMC Infectious Diseases, vol. 19, no. 1, May 2019, p. 451. EBSCOhost, doi:10.1186/s12879-019-4094-0.
    • Chicago/Turabian: Humanities:
      Herath, Nalaka, Wimalasiri Uluwattage, Theshanthi Weliwitiya, Lilani Karunanayake, Sarath Lekamwasam, Neelakanthi Ratnatunga, Panduka Karunanayake, et al. “Sequel and Therapeutic Modalities of Leptospirosis Associated Severe Pulmonary Haemorrhagic Syndrome (SPHS); a Sri Lankan Experience.” BMC Infectious Diseases 19, no. 1 (May 22, 2019): 451. doi:10.1186/s12879-019-4094-0.
    • Vancouver/ICMJE:
      Herath N, Uluwattage W, Weliwitiya T, Karunanayake L, Lekamwasam S, Ratnatunga N, et al. Sequel and therapeutic modalities of leptospirosis associated severe pulmonary haemorrhagic syndrome (SPHS); a Sri Lankan experience. BMC Infectious Diseases [Internet]. 2019 May 22 [cited 2020 Jan 18];19(1):451. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cmedm&AN=31113404