Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua.
Unsuspected leptospirosis is a cause of acute febrile illness in Nicaragua.
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尼加拉瓜的诱发诱发是急性发热疾病的原因。
DOI：
10.1371/journal.pntd.0002941
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发表时间：
2014-07
影响因子：
3.8
通讯作者：
Matute AJ
中科院分区：
文献类型：
--
作者：
Reller ME;Wunder EA Jr;Miles JJ;Flom JE;Mayorga O;Woods CW;Ko AI;Dumler JS;Matute AJ
流行性严重钩端螺旋体病于1995年在尼加拉瓜得到确认，但尚未得到确认的流行病和地方病仍未得到研究。为了确定尼加拉瓜症状性钩端螺旋体病的负担和危险因素，我们前瞻性研究了一家大型教学医院的发热患者。流行病学和临床特征进行了系统的记录，并成对血清检测IgM-ELISA，以确定可能的和可能的急性钩端螺旋体病患者。用显微凝集试验和PCR方法确诊急性钩端螺旋体病。在704例患者的配对血清检测MAT，44例急性钩端螺旋体病。急性钩端螺旋体病患者更有可能出现在多雨的月份，并报告农村居住和淡水暴露。ELISA检测急性期IgM和临床症状的敏感性较差。在尼加拉瓜，钩端螺旋体病是一种常见的（6.3%）但未被识别的急性发热性疾病。需要支持早期诊断和治疗的快速床旁检测以及支持基于人群的研究的检测，以描述钩端螺旋体病的流行病学、发病率和临床谱，两者都是理想的基于病原体的。钩端螺旋体病是由钩端螺旋体属细菌的致病性物种传播的，在世界范围内分布，但由于未被认识到的流行病或地方病引起的感染未得到充分重视。我们前瞻性研究了尼加拉瓜≥2岁的急性发热性疾病患者，并系统收集了有关疾病暴露和特征以及血清和血液的详细信息，以确认急性感染。用MAT检测704例患者的配对血清，发现急性钩体病44例（6.3%）。急性钩端螺旋体病患者更有可能出现在多雨的月份，并报告农村居住和淡水暴露。在尼加拉瓜，钩端螺旋体病是一种常见的（6.3%）但未被识别的急性发热性疾病。
Epidemic severe leptospirosis was recognized in Nicaragua in 1995, but unrecognized epidemic and endemic disease remains unstudied. To determine the burden of and risk factors associated with symptomatic leptospirosis in Nicaragua, we prospectively studied patients presenting with fever at a large teaching hospital. Epidemiologic and clinical features were systematically recorded, and paired sera tested by IgM-ELISA to identify patients with probable and possible acute leptospirosis. Microscopic Agglutination Test and PCR were used to confirm acute leptospirosis. Among 704 patients with paired sera tested by MAT, 44 had acute leptospirosis. Patients with acute leptospirosis were more likely to present during rainy months and to report rural residence and fresh water exposure. The sensitivity of clinical impression and acute-phase IgM detected by ELISA were poor. Leptospirosis is a common (6.3%) but unrecognized cause of acute febrile illness in Nicaragua. Rapid point-of-care tests to support early diagnosis and treatment as well as tests to support population-based studies to delineate the epidemiology, incidence, and clinical spectrum of leptospirosis, both ideally pathogen-based, are needed. Leptospirosis, transmitted by pathogenic species of the bacterium Leptospira, is distributed worldwide but infections due to unrecognized epidemic or endemic disease are under-appreciated. We prospectively studied patients ≥2 years of age who presented with acute febrile illness in Nicaragua and systematically collected detailed information about exposures and features of the illness as well as serum and blood to confirm acute infections. Among 704 patients with paired sera tested by MAT, we found acute leptospirosis in 6.3% (44/704). Patients with acute leptospirosis were more likely to present during rainy months and to report rural residence and fresh water exposure. Leptospirosis is a common (6.3%) but unrecognized cause of acute febrile illness in Nicaragua.
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影响因子：
8.4
作者：
Spichler, Anne;Athanazio, Daniel;Seguro, Antonio C.;Vinetz, Joseph M.
通讯作者：
Vinetz, Joseph M.
影响因子：
13.6
作者：
Cumberland, P;Everard, COR;Levett, PN
通讯作者：
Levett, PN
DOI：
10.4269/ajtmh.1966.15.735
发表时间：
1966-01-01
影响因子：
3.3
作者：
CLARK, LG;VARELADI.VM;HOLLISTER, CJ
通讯作者：
HOLLISTER, CJ
影响因子：
4.9
作者：
Ressner, Roseanne A.;Griffith, Matthew E.;Murray, Clinton K.
通讯作者：
Murray, Clinton K.
DOI：
10.4269/ajtmh.1966.15.57
发表时间：
1966-01-01
影响因子：
3.3
作者：
MACKENZIE, RB;REILEY, CG;BEYE, HK
通讯作者：
BEYE, HK