Assessment of the clinical presentation and treatment of 353 cases of laboratory confirmed leptospirosis in Hawaii, 1974-1998
Assessment of the clinical presentation and treatment of 353 cases of laboratory confirmed leptospirosis in Hawaii, 1974-1998
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DOI：
10.1086/324084
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发表时间：
2001-12-01
影响因子：
11.8
通讯作者：
Sasaki, DM
中科院分区：
文献类型：
--
作者：
Katz, AR;Ansdell, VE;Sasaki, DM
钩端螺旋体病是经常误诊的结果，其多变的和非特异性的介绍。钩端螺旋体病是一种全球分布的人畜共患病，通常发生在热带和亚热带地区;美国报告的大多数病例发生在夏威夷。对1974年至1998年夏威夷州所有实验室确诊的钩端螺旋体病病例（n = 353）进行了临床评价。最常见的表现涉及非特异性体征或症状，包括发热、肌痛和头痛。39%的病例发生结膜炎; 28%的病例描述了结膜窒息。在出现症状的第七天之前开始使用抗生素与疾病持续时间显著缩短相关。由于早期识别和开始抗生素治疗很重要，临床医生应熟悉钩端螺旋体病的临床表现，当评估发热性疾病患者时，他们应获得暴露和旅行史，并在鉴别诊断中考虑钩端螺旋体病的可能性。
Leptospirosis is frequently misdiagnosed as a result of its protean and nonspecific presentation. Leptospirosis, a zoonosis with global distribution, commonly occurs in tropical and subtropical regions; most reported cases in the United States occur in Hawaii. All laboratory-confirmed leptospirosis cases in the State of Hawaii from 1974 through 1998 (n = 353) were clinically evaluated. The most common presentation involved nonspecific signs or symptoms, including fever, myalgia, and headache. Jaundice occurred in 39% of cases; conjunctival suffusion was described in 28% of these cases. Initiation of antibiotics before the seventh day of symptoms was associated with a significantly shortened duration of illness. Because early recognition and initiation of antibiotic therapy are important, clinicians should familiarize themselves with the clinical presentation of leptospirosis, and when evaluating a patient with a febrile illness, they should obtain exposure and travel histories and entertain the possibility of leptospirosis in the differential diagnosis.