Abstract
BACKGROUND: The symptoms of leptospirosis can range from mild pulmonary symptoms to acute respiratory distress syndrome (ARDS) and lung hemorrhage. As a result, a delayed diagnosis may have negative consequences. A cross-sectional study was conducted to determine the prevalence and spectrum of pulmonary manifestations in leptospirosis. METHODS: This cross-sectional study was conducted among patients admitted with febrile illness and diagnosed with leptospirosis by IgM anti-leptospiral antibodies. Clinical features, with special focus on pulmonary complaints, were recorded using a questionnaire. Presentations such as jaundice, oliguria, cough, hemoptysis, breathlessness, chest pain, evidence of ARDS, and pulmonary hemorrhage were noted. Chest X-rays were assessed for the presence of reticular infiltration and airspace nodules. The data were subjected to statistical analysis. RESULTS: The study included 50 patients (aged 18 to 80 years) who had been diagnosed with leptospirosis. Among the 50 patients, 42 (84%) were male; the mean age of the patients was 43.7 years. All patients experienced fever, followed by myalgia, which was noted in 45 (90%) patients. In 22 (44%) patients, pulmonary symptoms - including cough, breathlessness, and hemoptysis - were identified. Abnormal chest X-rays were noted in 10 (20%) patients, and the most common pattern that increased the likelihood of requiring artificial breathing was airspace nodules. Tachypnea and hemodynamic impairment were two parameters that significantly correlated with abnormal chest X-rays. There were 16 deaths, with the leading cause of death being pulmonary problems in 13 patients (81.25%), followed by acute renal failure in two patients (12.5%) and multi-organ dysfunction in one patient (6.25%). CONCLUSION: Leptospirosis frequently manifests as pulmonary symptoms, which are linked to a high death rate. Reducing mortality requires early detection and treatment.