Assessment of the Clinical Presentation and Treatment of 353 Cases of Laboratory-Confirmed Leptospirosis in Hawaii, 1974–1998
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...
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| Veröffentlicht in: | Clinical infectious diseases 2001-12, Vol.33 (11), p.1834-1841 |
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| container_title | Clinical infectious diseases |
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| creator | Katz, Alan R. Ansdell, Vernon E. Effler, Paul V. Middleton, Charles R. Sasaki, David M. |
| description | 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. |
| doi_str_mv | 10.1086/324084 |
| format | Article |
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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. 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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.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Antibiotics</subject><subject>Antimicrobials</subject><subject>Bacterial diseases</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Diseases</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Hawaii</subject><subject>Human bacterial diseases</subject><subject>Humans</subject><subject>Infant</subject><subject>Infectious diseases</subject><subject>Leptospira - isolation & purification</subject><subject>Leptospirosis</subject><subject>Leptospirosis - diagnosis</subject><subject>Leptospirosis - drug therapy</subject><subject>Leptospirosis - microbiology</subject><subject>Major Articles</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Notifiable diseases</subject><subject>Preventive medicine</subject><subject>Symptoms</subject><subject>Treatment Outcome</subject><subject>Tropical medicine</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0c1u1DAQB_AIgWgp8AQImQOcCHhiO7GPJVAWaSUQKgJxsbzJWLjsxqknq7YneAfekCfBVZbuCXHyx_xsy_MviofAXwDX9UtRSa7lreIQlGjKWhm4nedc6VJqoQ-Ke0RnnANoru4WBwC1qSojD4sfx0RItMFhYtGz6Ruydh2G0Lk1-5CQ8r6bQhyYG3p2mtBNf6lQgrUuH75eLN0qJjfFdFW2cfAhbbBnSxynSGNIkQKxMLCFu3AhPGdgGvn75y8wRt8v7ni3JnywG4-KTydvTttFuXz_9l17vCw7BWYqV6rxXokejay46Txi512Hpq-wFxVHtVLSy05pj3XPnVGuB2kEolG9FLUQR8Wz-d4xxfMt0mQ3gTpcr92AcUu2qSqlc1v-C0FLxRvQe9jl_1FCb8cUNi5dWeD2OhM7Z5Lh492N21Vuy57tQsjg6Q44yn33yQ1doL2TIAXwJrsns4vb8d-PPZrNGeU0bpSUujIccrmcy4EmvLwpu_Td1o1olF18-WoX5jX__OrkowXxB5tctg8</recordid><startdate>20011201</startdate><enddate>20011201</enddate><creator>Katz, Alan R.</creator><creator>Ansdell, Vernon E.</creator><creator>Effler, Paul V.</creator><creator>Middleton, Charles R.</creator><creator>Sasaki, David M.</creator><general>The University of Chicago Press</general><general>University of Chicago Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20011201</creationdate><title>Assessment of the Clinical Presentation and Treatment of 353 Cases of Laboratory-Confirmed Leptospirosis in Hawaii, 1974–1998</title><author>Katz, Alan R. ; Ansdell, Vernon E. ; Effler, Paul V. ; Middleton, Charles R. ; Sasaki, David M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c519t-b57ff53de94209cfeecface9d2ed320e5b54f4c58fe6d0a95ad1493ee95d43633</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Anti-Bacterial Agents - therapeutic use</topic><topic>Antibiotics</topic><topic>Antimicrobials</topic><topic>Bacterial diseases</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Diseases</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Hawaii</topic><topic>Human bacterial diseases</topic><topic>Humans</topic><topic>Infant</topic><topic>Infectious diseases</topic><topic>Leptospira - isolation & purification</topic><topic>Leptospirosis</topic><topic>Leptospirosis - diagnosis</topic><topic>Leptospirosis - drug therapy</topic><topic>Leptospirosis - microbiology</topic><topic>Major Articles</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Notifiable diseases</topic><topic>Preventive medicine</topic><topic>Symptoms</topic><topic>Treatment Outcome</topic><topic>Tropical medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Katz, Alan R.</creatorcontrib><creatorcontrib>Ansdell, Vernon E.</creatorcontrib><creatorcontrib>Effler, Paul V.</creatorcontrib><creatorcontrib>Middleton, Charles R.</creatorcontrib><creatorcontrib>Sasaki, David M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Katz, Alan R.</au><au>Ansdell, Vernon E.</au><au>Effler, Paul V.</au><au>Middleton, Charles R.</au><au>Sasaki, David M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of the Clinical Presentation and Treatment of 353 Cases of Laboratory-Confirmed Leptospirosis in Hawaii, 1974–1998</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2001-12-01</date><risdate>2001</risdate><volume>33</volume><issue>11</issue><spage>1834</spage><epage>1841</epage><pages>1834-1841</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><coden>CIDIEL</coden><abstract>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. 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| source | MEDLINE; JSTOR Archive Collection A-Z Listing; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals |
| subjects | Adolescent Adult Aged Anti-Bacterial Agents - therapeutic use Antibiotics Antimicrobials Bacterial diseases Biological and medical sciences Child Child, Preschool Diseases Epidemiology Female Hawaii Human bacterial diseases Humans Infant Infectious diseases Leptospira - isolation & purification Leptospirosis Leptospirosis - diagnosis Leptospirosis - drug therapy Leptospirosis - microbiology Major Articles Male Medical sciences Middle Aged Miscellaneous Morbidity Mortality Notifiable diseases Preventive medicine Symptoms Treatment Outcome Tropical medicine |
| title | Assessment of the Clinical Presentation and Treatment of 353 Cases of Laboratory-Confirmed Leptospirosis in Hawaii, 1974–1998 |
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