Radiographic Chest Findings and Clinical Correlations in Leptospirosis
Orasa Chawalparit MD*, Apinya Charoensak MD*, Kanigar Niwattayakul MD**, Chuanpit Suttinont PhD***, Kitti Losuwanaluk MD****, Saowaluk Silpasakorn MD*****, Yupin Suputtamongkol MD*****
Affiliation : * Department of Radiology, Faculty of Medicine at Siriraj Hospital, Mahidol University, Bangkok ** Department of Medicine, Loei Hospital, Loei *** Department of Medicine, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima **** Banmai Chaiyapod Hospital, Bureerum ***** Department of Medicine, Faculty of Medicine at Siriraj Hospital, Mahidol University, Bangkok
Objective : To determine the clinical presentations, radiographic chest findings, and their correlation in
patients with leptospirosis.
Design : A cross sectional study.
Setting : Between July 2001- December 2002 at 3 hospitals in North Eastern Thailand.
Materials and Methods : Two hundred and forty patients with laboratory confirmed leptospirosis.
Results : Two hundred and nine (87.1%) patients were males. The mean age was 37.53 years (range 13-76).
The median duration of fever was 3 days (range 1-13). Overall, 154 patients (64.2%) had respiratory symp-
toms and 26 (10.8%) patients had hemoptysis. Jaundice was detected in 76 (31.7%) patients, hypotension in
50 (20.8%), renal dysfunction in 80 (30%), and multiorgan dysfunction in 62 (25.8%) on admission. One
hundred and fifty-four (64.17%) patients had abnormal chest radiographs on admission (classified as cardio-
vascular, pulmonary, and mixed cardio-pulmonary involvement in 40 (25.97%), 41 (26.62%), and 73 (47.4%)
patients, respectively). Jaundice was significantly associated with the likelihood of having abnormal chest
radiography on admission. Air- space nodules detected on the chest radiograph were significantly more
common in patients with renal dysfunction and patients who required mechanical ventilation.
Conclusion : Pulmonary and cardiovascular involvements are common in leptospirosis. Air-space nodules
detected by chest radiography may indicate severe leptospirosis.
Keywords : Leptospirosis, Chest radiograph, Pulmonary
