Journal Article

Assessment of the Clinical Presentation and Treatment of 353 Cases of Laboratory-Confirmed Leptospirosis in Hawaii, 1974–1998

Alan R. Katz, Vernon E. Ansdell, Paul V. Effler, Charles R. Middleton and David M. Sasaki

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 33, issue 11, pages 1834-1841
Published in print December 2001 | ISSN: 1058-4838
Published online December 2001 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/324084
Assessment of the Clinical Presentation and Treatment of 353 Cases of Laboratory-Confirmed Leptospirosis in Hawaii, 1974–1998

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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.

Journal Article.  5150 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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