1421. Evaluation of the Modified WHO Faine’s Criteria for diagnosing Human Leptospirosis in a Tertiary Care Hospital of North India.
Session: Poster Abstract Session: Public Health
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Poster-IDSA2016.pdf (4.3 MB)
  • Background: Leptospirosis is an important tropical infectious disease that affects the Indian sub-continent. This study evaluated the Modified WHO Faines criteria for diagnosing human Leptospirosis in a tertiary care hospital of North India.

    Methods:Prospective observational study held over 1 year. Inclusion criteria: All cases presenting with symptoms of part A of the WHO modified Faine's criteria.

    Results: Out of 71 cases, the male female ratio was 1.5:1 and mean age 36.8±15.6 years. Fifty one percent of our cases had contact with flood/stagnant water and 48% with livestock and stray animals. Prominent clinical features were headache (38%), conjuctival suffusion (13.6%), jaundice (60%), myalgias (52%) and vomiting (44%). Physical findings were pitting oedema (44%), rash (17%), hepatomegaly (50%), ascites (31%), pleural effusion (18%) and splenomegaly (45%). Co-infections present in our patients were; enteric fever in 2 cases, malaria in 6 cases, dengue fever in 6 cases and viral hepatitis in 3. Disease complications observed in our cases were acute respiratory distress syndrome in 47%, clinical bleeding in 20% and acute renal failure in 52%. SOFA scores were calculated and in 38 patients ranged from 2-7, in 22 patients from 8-11 and in 4 cases was greater than 11. Fifty four patients were treated with ceftriaxone and levofloxacin in 5, azithromycin in 4, doxycycline in 3 and artesunate in 3. The case fatality rate in our study was 10.6% (7 cases).

    Of the eight serovars seen in this study, the commonest identified were; icterohaemorrhigica in 94%, grippotyphosa in 59% and javanica in 44%. On applying the WHO modified Faines criteria for diagnosing leptospirosis revealed a sensitivity of 3.03%, specificity of 80%, positive predictive value of 66%.

    Conclusion: Although, the WHO modified Faine's criteria have good specificity and a moderate positive predictive value in diagnosing human leptospirosis, yet, the presence of other tropical infections with similar clinical features resulted in a much lower sensitivity.

    Navneet Sharma, MD1, Sunil Sethi, MD2 and Ashish Bhalla, MD1, (1)Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India, (2)Microbiology, Postgraduate Institute of Medical Education & Research, Chandigarh, India

    Disclosures:

    N. Sharma, None

    S. Sethi, None

    A. Bhalla, None

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