Leptospirosis in Chonbuk Province of Korea in 1987

Abstract

Leptospirosis is a zoonosis with protean clinical manifestations. Its diagnosis requires a high index of suspicion and is confirmed by isolation of the organism or, more commonly, by serologic tests. In the fall of 1987, after severe flooding, we saw 93 patients with leptospirosis, confirmed by a microagglutination test. Thirteen percent of the patients had no clinical or laboratory findings except fever and headache, but the rest had mild to severe manifestations. Jaundice, renal failure, and aseptic meningitis were not common, but pulmonary symptoms, when present, were striking. The mortality rate was 5%. The main cause of death was asphyxiation due to massive hemoptysis from pulmonary hemorrhage and acute respiratory failure.

Fig. 1.

Age and Sex of Patients with Leptospirosis

Fig. 2.

Graph Summarizing Monthly Distribution of Leptospirosis, Tsutsugamush Disease, and Hemorrhagic Fever with Renal Syndrome

Fig. 3.

Clinical Types in 93 Patients with Leptospirosis ^*Meningitis

Fig. 4.

Photomicrograph of the lung showing intra-alveloar fibrin exudation. A few blood cells are seen in the alveoli. The septa are thin and delicate. H&E ×150.

Fig. 5.

Photomicrograph of the kidney showing degeneration of tubular epithelial cells and infiltration of a few mononuclear cells. H&E ×400.

Fig. 6.

Photomicrograph of the calf muscle showing interstitial hemorrhage and a mild small round cell infiltration. H&E ×150

Fig. 7.

Photomicrograph of the heart showing interstitial edema, inflammatory cell infiltration, and focal myocardial cell degeneration. H& ×150

Fig. 8.

Photomicrograph of the liver showing portal tract inflammatory extention into the lobule. The inflammatory cells are composed of monocytes, plasma cells, lymphocytes, and some neutrophils. H&E ×400