2022
Vaccination With Leptospira interrogans PF07598 Gene Family-Encoded Virulence Modifying Proteins Protects Mice From Severe Leptospirosis and Reduces Bacterial Load in the Liver and Kidney
Chaurasia R, Salovey A, Guo X, Desir G, Vinetz JM. Vaccination With Leptospira interrogans PF07598 Gene Family-Encoded Virulence Modifying Proteins Protects Mice From Severe Leptospirosis and Reduces Bacterial Load in the Liver and Kidney. Frontiers In Cellular And Infection Microbiology 2022, 12: 926994. PMID: 35837473, PMCID: PMC9274288, DOI: 10.3389/fcimb.2022.926994.Peer-Reviewed Original ResearchConceptsLethal challenge infectionChallenge infectionBacterial loadC3H/HeJ miceKey target organClinical pathogenesisSevere leptospirosisOrgan infectionProtein immunizationHeJ miceSerovar CanicolaTarget organsAnimal modelsLeptospirosis pathogenesisCellular pathogenesisMicePathogenesisInfectionLeptospira interrogansVirulence factorsModifying proteinsImmunizationKidneyLeptospirosisLiver
2021
Genetic Evidence for a Potential Environmental Pathway to Spillover Infection of Rat-Borne Leptospirosis
Casanovas-Massana A, de Oliveira D, Schneider AG, Begon M, Childs JE, Costa F, Reis MG, Ko AI, Wunder EA. Genetic Evidence for a Potential Environmental Pathway to Spillover Infection of Rat-Borne Leptospirosis. The Journal Of Infectious Diseases 2021, 225: 130-134. PMID: 34139761, PMCID: PMC8730487, DOI: 10.1093/infdis/jiab323.Peer-Reviewed Original ResearchConceptsPotential environmental pathwaysEnvironmental reservoirsSpillover infectionsEnvironmental pathwaysHuman leptospirosis casesSevere leptospirosisLeptospirosis infectionLeptospirosis casesMolecular epidemiologyGenetic evidencePathogenic LeptospiraLeptospira interrogansInfectionLeptospirosisUrban slumsSpillover pathwaysRat specimensReservoirPathwayUrban communitiesCommunityEpidemiology
2020
79 Leptospirosis
Vinetz J, Watt G. 79 Leptospirosis. 2020, 636-640. DOI: 10.1016/b978-0-323-55512-8.00079-x.Peer-Reviewed Original ResearchSevere leptospirosisAcute kidney injuryEndothelial cell dysfunctionKey pathologic featuresThird-generation cephalosporinsMarked functional impairmentHigh mortality ratePathogenesis of leptospirosisMost disease transmissionRefractory shockKidney injuryOral doxycyclineParenteral penicillinPulmonary hemorrhageSubstantial morbidityPathologic featuresHistopathologic changesFunctional impairmentAvailable vaccinesCell dysfunctionDiagnostic confirmationRisk populationsMilder casesMortality rateLeptospirosis
2019
Elevated Activation of Neutrophil Toll-Like Receptors in Patients with Acute Severe Leptospirosis: An Observational Study.
Lindow JC, Tsay AJ, Montgomery RR, Reis EAG, Wunder EA, Araújo G, Nery NRR, Mohanty S, Shaw AC, Lee PJ, Reis MG, Ko AI. Elevated Activation of Neutrophil Toll-Like Receptors in Patients with Acute Severe Leptospirosis: An Observational Study. American Journal Of Tropical Medicine And Hygiene 2019, 101: 585-589. PMID: 31333152, PMCID: PMC6726964, DOI: 10.4269/ajtmh.19-0160.Peer-Reviewed Original ResearchConceptsSevere leptospirosisActivation markersDisease severityNeutrophil Toll-like receptorToll-like receptor 2Acute severe leptospirosisHospitalized leptospirosis patientsNeutrophil activation markersEarly immune responseToll-like receptorsSevere disease outcomesHigh initial bacterial loadFebrile infectionsOrgan dysfunctionLeptospirosis patientsPeripheral neutrophilsNeutrophil responseHealthy controlsImmune mechanismsDisease outcomeObservational studyImmune responseSevere diseaseReceptor 2Tissue damageSevere Leptospirosis Features in the Spleen Indicate Cellular Immunosuppression Similar to That Found in Septic Shock
Duarte-Neto A, Croda J, Pagliari C, Soriano F, Nicodemo A, Duarte M. Severe Leptospirosis Features in the Spleen Indicate Cellular Immunosuppression Similar to That Found in Septic Shock. Frontiers In Immunology 2019, 10: 920. PMID: 31114579, PMCID: PMC6503108, DOI: 10.3389/fimmu.2019.00920.Peer-Reviewed Original ResearchConceptsSeptic shockLeptospirosis patientsSevere leptospirosisPulmonary hemorrhagePositive cellsRed pulpBacterial septic shockSeptic shock patientsCaspase-3-positive cellsImmune cell markersSpleen of patientsActive caspase-3 positive cellsSemi-quantitative scoreImmunomodulatory treatmentShock patientsCellular immunosuppressionIL-10Immunologic featuresImmunosuppressive stateMarked atrophyEndothelial activationControl spleensHistological featuresIntense infiltrationPlasma cellsAn outbreak of leptospirosis with predominant cardiac involvement: a case series
Jayathilaka PGNS, Mendis ASV, Perera MHMTS, Damsiri HMT, Gunaratne AVC, Agampodi SB. An outbreak of leptospirosis with predominant cardiac involvement: a case series. BMC Infectious Diseases 2019, 19: 265. PMID: 30885170, PMCID: PMC6423826, DOI: 10.1186/s12879-019-3905-7.Peer-Reviewed Original ResearchConceptsColombo North Teaching HospitalCardiac involvementMulti-organ dysfunctionCase seriesSevere leptospirosisTeaching hospitalDynamic T-wave changesInotropic/vasopressor supportNon-specific clinical findingsEvidence of myocarditisPredominant cardiac involvementRapid atrial fibrillationSingle medical wardAcute kidney injuryMean arterial pressureStudy of patientsCourse of illnessT-wave changesCase presentationWe reportOutbreak of leptospirosisPossible leptospirosisResidual complicationsVasopressor supportKidney injuryCommon complication
2016
Severe leptospirosis and pancreatitis; A case series from a leptospirosis outbreak in Anuradhapura district, Sri Lanka
Herath NJ, Kamburapola CJ, Agampodi SB. Severe leptospirosis and pancreatitis; A case series from a leptospirosis outbreak in Anuradhapura district, Sri Lanka. BMC Infectious Diseases 2016, 16: 644. PMID: 27821124, PMCID: PMC5100107, DOI: 10.1186/s12879-016-2010-4.Peer-Reviewed Original ResearchConceptsIntensive care unitSevere leptospirosisCase seriesConclusionThis case seriesResidual organ damageAcute kidney injuryLow serum calciumAnuradhapura districtBackgroundAcute pancreatitisAbdominal painKidney injurySix patientsCommon complicationCare unitClinical presentationElevated amylaseOrgan damageRare presentationSerum calciumAcute pancreatitisCase presentationWeNeutrophilic leukocytosisMain complicationsSerum amylaseTeaching hospital
2008
Predictors of lethality in severe leptospirosis in urban Brazil.
Spichler AS, Vilaça PJ, Athanazio DA, Albuquerque JO, Buzzar M, Castro B, Seguro A, Vinetz JM. Predictors of lethality in severe leptospirosis in urban Brazil. American Journal Of Tropical Medicine And Hygiene 2008, 79: 911-4. PMID: 19052303, PMCID: PMC2640419, DOI: 10.4269/ajtmh.2008.79.911.Peer-Reviewed Original ResearchConceptsSevere leptospirosisRetrospective case-control studyPopulation-based surveillance dataDevelopment of oliguriaPredictors of deathStrong risk factorCase-control studyPredictors of lethalityDeath certificate reportingLung involvementPulmonary involvementPrognostic factorsSerologic findingsFatal outcomePatient hospitalizationRisk factorsSurvivor casesOdds ratioLethal casesHigh titersLeptospirosis casesSurveillance dataLeptospira interrogansLeptospirosisHospitalization
2007
Reversal of renal tubule transporter downregulation during severe leptospirosis with antimicrobial therapy.
Spichler A, Ko AI, Silva EF, De Brito T, Silva AM, Athanazio D, Silva C, Seguro A. Reversal of renal tubule transporter downregulation during severe leptospirosis with antimicrobial therapy. American Journal Of Tropical Medicine And Hygiene 2007, 77: 1111-9. PMID: 18165532, DOI: 10.4269/ajtmh.2007.77.1111.Peer-Reviewed Original ResearchMeSH KeywordsAcetylcysteineAmpicillinAnimalsAnti-Bacterial AgentsAntigens, BacterialCricetinaeDown-RegulationFemaleFree Radical ScavengersGene Expression ProfilingGene Expression RegulationKidneyLiverMesocricetusSodium-Hydrogen Exchanger 3Sodium-Hydrogen ExchangersSodium-Potassium-Chloride SymportersSolute Carrier Family 12, Member 1ThiobarbituratesWeil DiseaseConceptsSevere leptospirosisAntimicrobial therapyN-acetylcysteineSerum thiobarbituric acidEvidence of benefitThick ascending limbNKCC2 transportersRenal involvementRenal expressionTubular dysfunctionAntioxidant therapyInfected hamstersTubular defectsNAC effectAscending limbAmpicillin treatmentRenal transportersTherapyTarget tissuesLeptospiral antigensAMP treatmentType 3Reduced levelsTransporter downregulationNormal expression
2002
Population-based case-control investigation of risk factors for leptospirosis during an urban epidemic.
Sarkar U, Nascimento S, Barbosa R, Martins R, Nuevo H, Kalofonos I, Kalafanos I, Grunstein I, Flannery B, Dias J, Riley L, Reis M, Ko A. Population-based case-control investigation of risk factors for leptospirosis during an urban epidemic. American Journal Of Tropical Medicine And Hygiene 2002, 66: 605-10. PMID: 12201599, DOI: 10.4269/ajtmh.2002.66.605.Peer-Reviewed Original ResearchConceptsRisk factorsUrban epidemicPopulation-based case-control studyPopulation-based case-control investigationIndependent risk factorLaboratory-confirmed casesHealthy neighbourhood controlsCase-control investigationCase-control studyCases of leptospirosisSevere leptospirosisWeil's syndromeWorkplace exposuresNeighborhood controlsHigh endemicityLeptospirosisFocused interventionsMore ratsSyndromeRatsEpidemicEnvironmental sourcesComplicationsFactorsMortality
1999
Urban epidemic of severe leptospirosis in Brazil
Ko A, Reis M, Dourado C, Johnson W, Riley L, Group S. Urban epidemic of severe leptospirosis in Brazil. The Lancet 1999, 354: 820-825. PMID: 10485724, DOI: 10.1016/s0140-6736(99)80012-9.Peer-Reviewed Original ResearchConceptsDengue feverInfectious disease referral hospitalAggressive supportive careEpidemic of leptospirosisStrong independent predictorPositive blood culturesLarge urban outbreaksIdentification of leptospiresRenal insufficiencyRespiratory insufficiencySevere leptospirosisSupportive careIndependent predictorsReferral hospitalOutpatient clinicSevere anemiaSevere manifestationsActive surveillanceMental statusRisk factorsBlood culturesDiagnostic confusionUrban epidemicMicroagglutination testUrban outbreaks
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