ABSTRACT
Objective: To determine the place of routinely used biochemical tests in the diagnosis of leptospirosis.
Method: This is a retrospective case-control study. Patients hospitalized with fever and acute kidney failure and diagnosed as leptospirosis were accepted as case group; other infectious and non-infectious diseases with similar clinical findings as control. Patients were evaluated retrospectively. The sensitivity, specificity, negative and positive predictive values of various clinical and laboratory tests were calculated by comparing two group of patients.
Results: This study was evaluated 66 patients with leptospirosis and 66 control cases. There are fever and acute kidney failure in these 132 patients. Presence of farming/handling livestock, myalgia, hemorrhage, oliguria, hypotension and infiltration at pulmonary x-ray was significantly higher in case group (p<0.05). Hemoglobin and platelet levels were significantly lower, and blood urea nitrogen, creatinine, total and direct bilirubin, creatine phosphokinase, C-reactive protein, activated partial thromboplastin time were significantly higher in case group (p<0.05). The highest sensitivity in predicting leptospirosis was determined in the platelet count and creatinine levels and the highest specificity in the total and direct bilirubin levels.
Conclusion: Leptospirosis should particularly be considered in cases of fever and acute kidney failure from rural areas with a history of frequent contact with soil or farming/handling livestock. Various clinical and laboratory parameters capable of routine use are able to differentiate the disease from other cases with similar clinical and laboratory findings. Early diagnosis and treatment are of vital importance in patients with leptospirosis.
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