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©The Author(s) 2025.
World J Clin Cases. Sep 6, 2025; 13(25): 106335
Published online Sep 6, 2025. doi: 10.12998/wjcc.v13.i25.106335
Published online Sep 6, 2025. doi: 10.12998/wjcc.v13.i25.106335
Table 1 Modified Faine’s criteria scoring system to diagnose leptospirosis
Part A: Clinical features | Score | Part B: Epidemiological factors | Score |
Headache | 2 | Contact with contaminated environment | 4 |
Fever ≥ 39°C | 2 | Occupation involving animals or contaminated water | 4 |
Conjunctival suffusion | 4 | Rainfall | 5 |
Muscle pain | 4 | Part C: Laboratory findings | Score |
Meningism | 4 | Positive IgM ELISA | 15 |
Jaundice | 1 | Positive PCR | 15 |
Albuminuria or nitrogen retention | 2 | Culture positive | 10 |
Hemorrhages | 2 | MAT titer ≥ 1:400 | 15 |
Cough, hemoptysis, or breathlessness | 2 | MAT titer ≥ 1:800 | 20 |
Interpretation of scores | |||
Presumptive diagnosis of leptospirosis: Total score (Parts A + B + C) ≥ 25; Total score (Parts A + B) ≥ 26 | Possible diagnosis of leptospirosis: Total score between 20 and 25 |
Table 2 Frequency of different symptoms, signs, and laboratory findings of the cohort, n (%)
Clinical variable | Frequency, n = 62 | No. of patients from Himalayan region, n = 20 | No. of patients from Sub-Himalayan region, n = 42 | P value |
Fever (> 39 °C) | 61 (98.39) | 20 (100.00) | 41 (97.62) | 1 |
Headache | 20 (32.26) | 7 (35.00) | 13 (30.95) | 0.977565281 |
Conjunctival suffusion | 9 (14.52) | 4 (20.00) | 5 (11.90) | 0.452540931 |
Neck rigidity | 4 (6.45) | 0 (0.00) | 4 (9.52) | 0.295162635 |
Myalgia | 26 (41.94) | 9 (45.00) | 17 (40.48) | 0.950434811 |
Jaundice | 13 (20.97) | 6 (30.00) | 7 (16.67) | 0.383257647 |
Dyspnea | 15 (24.19) | 7 (35.00) | 8 (19.05) | 0.291929299 |
Increased liver enzyme (> 3 × upper limit) | 39 (62.90) | 14 (70.00) | 25 (59.52) | 0.60511935 |
Thrombocytopenia | 45 (72.58) | 14 (70.00) | 31 (73.81) | 0.992162843 |
Edema | 7 (11.29) | 4 (20.00) | 3 (7.14) | 0.198564612 |
Abdominal pain | 27 (43.55) | 11 (55.00) | 16 (38.10) | 0.326599126 |
AKI | 25 (40.32) | 10 (50.00) | 15 (35.71) | 0.426604756 |
Hemodialysis Required | 14 (22.58) | 8 (40.00) | 6 (14.29) | 0.052520105 |
Altered sensorium | 16 (25.81) | 6 (30.00) | 10 (23.81) | 0.833434549 |
ARDS | 12 (19.35) | 7 (35.00) | 5 (11.90) | 0.070626099 |
CKD | 4 (6.45) | 2 (10.00) | 2 (4.76) | 0.588416137 |
DIC | 8 (12.90) | 2 (10.00) | 5 (11.90) | 1 |
MODS | 41 (66.13) | 13 (65.00) | 28 (66.67) | 1 |
HDU or ICU requirement | 37 (59.67) | 13 (65.00) | 24 (57.14) | 0.754549351 |
Table 3 Mortality rate amongst different subgroup of the cohort, n (%)
Clinical variable | Frequency, n = 62 | No. of patients from Himalayan region, n = 20 | No. of patients from sub-Himalayan region, n = 42 | P value |
Mortality | 13 (20.97) | 7 (35.00) | 6 (14.29) | 0.094 |
Table 4 Mortality rate as per system involvement in the cohort
System involvement | Discharged | Expired | Total | Mortality (%) |
Hematological + renal | 20 | 7 | 27 | 25.93 |
Hematological + renal + hepatic | 16 | 7 | 23 | 30.43 |
Hematological + renal + hepatic + respiratory | 6 | 3 | 9 | 33.33 |
- Citation: Das D, Ponnampurathu S, Panda PK, Mathuria YP. Different clinical profile of leptospirosis in a tertiary care Indian hospital: A Himalayan experience. World J Clin Cases 2025; 13(25): 106335
- URL: https://www.wjgnet.com/2307-8960/full/v13/i25/106335.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v13.i25.106335