Skip to content
2000
image of Clinical Profile and Severity Correlation of Acute Leptospirosis in Northern India, 2019-2023: A Tertiary Care Center-based Study

Abstract

Background

Leptospirosis is a globally important zoonotic disease with substantial morbidity and mortality, yet it remains underreported in Northern India. This study aimed to evaluate the seroprevalence, clinical characteristics, and severity determinants of acute leptospirosis in a tertiary care setting.

Methods

We conducted a retrospective cross-sectional analysis of 174 hospitalized leptospirosis patients from 20,162 admissions between 2019 and 2023. The diagnosis was established using Leptospira IgM ELISA testing. Clinical, haematological, and imaging parameters were systematically evaluated.

Results

The incidence of leptospirosis was 0.9%, peaking at 38.5% post-monsoon. Rural residents (64.9%), males (59.2%), and individuals involved in agricultural work (62.6%) were predominantly affected. Common presentations were fever (100%), headache (70.7%), myalgia (62%), and calf pain (50%), followed by jaundice (39.7%), and reduced urine output (33.3%).. The mortality rate was 20.1%. Severity correlated significantly with nausea/vomiting, abdominal pain, cough, and complications, including diffuse alveolar haemorrhage (DAH), disseminated intravascular coagulation (DIC), multiorgan dysfunction syndrome (MODS), hepatic dysfunction, acute renal injury, and leukocytosis.

Discussion

The findings emphasize the critical need for early risk stratification and timely intervention to improve clinical outcomes. Identifying clinical and laboratory predictors of severity can significantly guide early management strategies in endemic areas.

Conclusion

Several clinical and laboratory parameters are significant predictors of leptospirosis severity. Early recognition and risk stratification based on these indicators are crucial to improving patient outcomes. Enhanced surveillance, preventive measures, and clinician awareness are urgently needed to address this neglected tropical disease.

Loading

Article metrics loading...

/content/journals/raiad/10.2174/0127722708436787251112233505
2025-11-27
2026-03-03
Loading full text...

Full text loading...

References

  1. Dinkar A. Singh J. Yadav M. Leptospirosis associated digital gangrene of lower extremities: Two cases and review of literature. Infect. Disord. Drug Targets 2024 24 5 220124225941 10.2174/0118715265256882231128074609 38265373
    [Google Scholar]
  2. Rajapakse S. Leptospirosis: Clinical aspects. Clin. Med. (Lond.) 2022 22 1 14 17 10.7861/clinmed.2021‑0784 35078790
    [Google Scholar]
  3. Kembhavi R.S. Velhal G.D. Shah A.K. Epidemiological determinants of leptospirosis in rural and urban districts of Maharashtra, India. J. Family Med. Prim. Care 2021 10 9 3361 3367 10.4103/jfmpc.jfmpc_674_21 34760758
    [Google Scholar]
  4. Levett P.N. Leptospirosis. Clin. Microbiol. Rev. 2001 14 2 296 326 10.1128/CMR.14.2.296‑326.2001 11292640
    [Google Scholar]
  5. Haake D.A. Levett P.N. Leptospirosis in humans. Curr. Top. Microbiol. Immunol. 2015 387 65 97 10.1007/978‑3‑662‑45059‑8_5 25388133
    [Google Scholar]
  6. Benacer D. Thong K.L. Min N.C. Epidemiology of human leptospirosis in Malaysia, 2004–2012. Acta Trop. 2016 157 162 168 10.1016/j.actatropica.2016.01.031 26844370
    [Google Scholar]
  7. Sethi S. Sharma N. Kakkar N. Increasing trends of leptospirosis in northern India: A clinico-epidemiological study. PLoS Negl. Trop. Dis. 2010 4 1 579 10.1371/journal.pntd.0000579 20084097
    [Google Scholar]
  8. Holla R. Darshan B. Pandey L. Leptospirosis in coastal south india: A facility based study. BioMed Res. Int. 2018 2018 1 5 10.1155/2018/1759125 29862254
    [Google Scholar]
  9. Desai K.T. Patel F. Patel P.B. Nayak S. Patel N.B. Bansal R.K. A case–control study of epidemiological factors associated with leptospirosis in South Gujarat region. J. Postgrad. Med. 2016 62 4 223 227 10.4103/0022‑3859.188551 27763478
    [Google Scholar]
  10. Schneider M.C. Najera P. Pereira M.M. Leptospirosis in rio grande do sul, brazil: An ecosystem approach in the animal-human interface. PLoS Negl. Trop. Dis. 2015 9 11 0004095 10.1371/journal.pntd.0004095 26562157
    [Google Scholar]
  11. Deshmukh P. Narang R. Jain J. Leptospirosis in wardha district, central india—analysis of hospital based surveillance data. Clin. Epidemiol. Glob. Health 2019 7 1 102 106 10.1016/j.cegh.2018.02.005
    [Google Scholar]
  12. Ristow P. Bourhy P. Kerneis S. Biofilm formation by saprophytic and pathogenic leptospires. Microbiology 2008 154 5 1309 1317 10.1099/mic.0.2007/014746‑0 18451039
    [Google Scholar]
  13. Espeland E.M. Wetzel R.G. Complexation, stabilization, and uv photolysis of extracellular and surface-bound glucosidase and alkaline phosphatase: Implications for biofilm microbiota. Microb. Ecol. 2001 42 4 572 585 10.1007/s00248‑001‑1023‑7 12024240
    [Google Scholar]
  14. Rajapakse S. Rodrigo C. Balaji K. Fernando S.D. Atypical manifestations of leptospirosis. Trans. R. Soc. Trop. Med. Hyg. 2015 109 5 294 302 10.1093/trstmh/trv026 25813883
    [Google Scholar]
  15. Sambasiva R.R. Naveen G P B Agarwal SK Leptospirosis in India and the rest of the world. Braz. J. Infect. Dis. 2003 7 3 178 193 14499041
    [Google Scholar]
  16. DebMandal M Mandal S Pal NK Serologic evidence of human leptospirosis in and around Kolkata, India: A clinico–epidemiological study. Asian Pac. J. Trop. Med. 2011 4 12 1001 1006 10.1016/S1995‑7645(11)60234‑4 22118039
    [Google Scholar]
  17. Deodhar D. John M. Leptospirosis: Experience at a tertiary care hospital in northern India. Natl. Med. J. India 2011 24 2 78 80 21668048
    [Google Scholar]
  18. Baveja B. Palewar M.S. Joshi S. Karyakarte R. Seroprevalence of acute leptospirosis in a tertiary care hospital of western India. MGM J Med Sci 2022 9 4 517 521 10.4103/mgmj.mgmj_33_22
    [Google Scholar]
  19. Khositseth S. Sudjaritjan N. Tananchai P. Ong-ajyuth S. Sitprija V. Thongboonkerd V. Renal magnesium wasting and tubular dysfunction in leptospirosis. Nephrol. Dial. Transplant. 2007 23 3 952 958 10.1093/ndt/gfm698 17951309
    [Google Scholar]
  20. Sitprija V. Altered fluid, electrolyte and mineral status in tropical disease, with an emphasis on malaria and leptospirosis. Nat. Clin. Pract. Nephrol. 2008 4 2 91 101 10.1038/ncpneph0695 18227802
    [Google Scholar]
  21. De Silva N. Niloofa M.J.R. Fernando N. Changes in full blood count parameters in leptospirosis: A prospective study. Int. Arch. Med. 2014 7 1 31 10.1186/1755‑7682‑7‑31 25018781
    [Google Scholar]
  22. Pongpan S. Thanatrakolsri P. Vittaporn S. Khamnuan P. Daraswang P. Prognostic factors for leptospirosis infection severity. Trop. Med. Infect. Dis. 2023 8 2 112 10.3390/tropicalmed8020112 36828528
    [Google Scholar]
  23. Craig S.B. Graham G.C. Burns M.A. Dohnt M.F. Smythe L.D. McKay D.B. Haematological and clinical-chemistry markers in patients presenting with leptospirosis: A comparison of the findings from uncomplicated cases with those seen in the severe disease. Ann. Trop. Med. Parasitol. 2009 103 4 333 341 10.1179/136485909X435058 19508751
    [Google Scholar]
  24. Saengsuwan L. Chaimay B. Woradet S. Clinical factors associated with mortality among patients with leptospirosis: A systematic review. SCNJ 2021 8 185 197
    [Google Scholar]
  25. Thammakumpee K. Silpapojakul K. Borrirak B. Leptospirosis and its pulmonary complications. Respirology 2005 10 5 656 659 10.1111/j.1440‑1843.2005.00764.x 16268921
    [Google Scholar]
  26. Dinkar A. Singh J. Kumar N. Kumar K. COVID-19 associated pancytopenia (CAP): A clinical impact. Recent Adv. Inflamm. Allergy Drug Discov. 2023 17 1 71 78 10.2174/2772270817666221207094122 36475340
    [Google Scholar]
  27. Singh J. Dinkar A. Gupta P. Atam V. Vitamin B12 deficiency in northern India tertiary care: Prevalence, risk factors and clinical characteristics. J. Family Med. Prim. Care 2022 11 6 2381 2388 10.4103/jfmpc.jfmpc_650_21 36119310
    [Google Scholar]
  28. Singh J. Dinkar A. Singh S. Acute myocardial infarction associated with severe Plasmodium vivax malaria. J. Vector Borne Dis. 2020 57 2 193 196 10.4103/0972‑9062.310872 34290167
    [Google Scholar]
  29. Singh J. Dinkar A. Atam V. Misra R. Kumar S. A deadly combination of acute encephalitis and gastric hemorrhage in dengue fever: A rare case. J Med Sci Clin Res 2014 2 3187 3193
    [Google Scholar]
  30. Kaur P. Singh K. Oberoi L. Sidhu S.K. Singh A. Seroprevalence and clinico-epidemiological profile of leptospirosis in acute febrile illness cases at a medical college in amritsar, punjab, india. J. Clin. Diagn. Res. 2022 16 8 DC39 DC43 10.7860/JCDR/2022/56636.16750
    [Google Scholar]
/content/journals/raiad/10.2174/0127722708436787251112233505
Loading
/content/journals/raiad/10.2174/0127722708436787251112233505
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test