Pulmonary radiographic findings in 118 leptospirosis patients

Abstract

We retrospectively reviewed the medical records and chest radiographs of 118 patients who presented during January 1998 to October 2002 at Songklanagarin Hospital in Hat Yai, Songkhla Province, Thailand who had a high serum immunofluorescent assay titer for leptospirosis. Twenty-nine of 118 (24%) patients had abnormal chest films. Nearly all of these patients had respiratory symptoms and needed oxygen therapy (93% and 90%, respectively). Forty-eight of the 118 (40%) had respiratory symptoms, but only 27/48 (56%) had abnormal radiographs. Twenty-one of the 28 (75%) and 18/27 (67%) who had abnormal chest radiographs had coexisting impaired renal function or jaundice, respectively, whereas 21/69 (30%) of the patients who had impaired renal function and 18/55 (33%) of the patients with jaundice had abnormal radiographs. There were 6/27 (22%) patients who had abnormal chest radiographs without renal or liver impairment. The most common finding on the abnormal chest radiograph was bilateral diffuse air space disease, which resolved within 7 days. No permanent lung damage was seen. The patients who had an abnormal chest radiograph needed longer hospitalization, than those without an abnormal chest radiograph (average 12 days and 5 days, respectively).