Proporción de leptospirosis y factores relacionados en pacientes con diagnóstico presuntivo de dengue, 2010-2012

Abstract

Objective Using the microscopic agglutination test (MAT) from 2010-2012 for identifying leptospirosis-related and sociodemographic variables in patients having a confirmed diagnosis of dengue and those for whom it had been discarded. Materials and Methods This was a retrospective study of 238 sera samples. 106 patients died, 64 of their samples were negative for dengue and 42 proved positive. 132 samples from live patients proved positive for dengue; 29 were confirmed by PCR and/or virus isolation and 103 had positive IgM readings. MAT was used for all sera and diagnosing Leptospira, epidemiological records were reviewed and the data was analysed. Results 42 dengue positive patients died; 3 (7 %) were positive for Leptospira interrogans serogroup Australis autumnalis (two girls aged 5 and 17 years-old and a 14 year-old boy). Of the 64 deceased patients who proved negative for dengue, 7 (11 %) were found positive for L. interrogans from serogroups Pomona, Autumnalis, Canicola and Ballum (5 males aged 8 to 58 years-old and 2 women aged 35 and 56 years-old). Of the 103 living patients who proved positive for dengue IgM, 3 (2.9 %) were positive for Leptospira icterohaemorrhagiae from the Cynopteri, Javanica Proechimys and Autumnalis serogroups (1 male and 2 females). None of the 29 living patients confirmed as having dengue were positive for Leptospira. Conclusions Leptospirosis should be suspected not only as the sole causative agent of febrile syndrome but also of co-infection which could compromise a patient and be related to mortality.