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Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
T Staphylococcus aureus toxic shock syndromeAny puerperal pyrexia associated with a widespread rash should suggest early toxic shock syndrome, especially if there is associated conjunctival hyperaemia or suffusion. A generalized macular rash is present in most cases of staphylococcal toxic shock syndrome but in only 10% of streptococcal toxic shock syndrome. Conjunctival suffusion is a classic sign of toxic shock syndrome. (Bacterial Sepsis Following Pregnancy. Royal College of Obstetricians and Gynaecologists Green-top Guideline No. 64b, April 2012)
Prognosis and Impact of Recurrent Uveitis, the Ophthalmic Infection Caused by Leptospira spp.
Published in K. Balamurugan, U. Prithika, Pocket Guide to Bacterial Infections, 2019
Charles Solomon Akino Mercy, Kalimuthusamy Natarajaseenivasan
Autoimmunity plays an important role in the ocular pathogenesis. Leptospirosis occurs biphasic in which an acute or septicemic phase lasts about a week and is characterized by high fevers (39°C–41°C) for 7–9 days after the initial exposure; a second immune phase occurs during the second week of illness, in which the disappearance of the organism from the bloodstream coincides with the appearance of antibodies. After the initial bacteremia the leptospires are eliminated by the immune system from all host tissues except from immunologically privileged places like the brain or eyes, resulting in immunological pathology in the eyes like uveitis (2 days to 4 weeks). Leptospiral antibodies are first detectable in serum 4–8 days after exposure and may be maintained for at least 7 years. Conjunctival suffusion is seen in most patients in some series. Uveitis may present weeks, months, or occasionally years after the acute stage. Chronic visual disturbance can persist 20 years or more after the acute illness. Chronic uveitis develops after a few days of unrelenting severe inflammation or following multiple recurrent episodes of uveitis (Gilger 2016).
Elevated levels of IL-8 in fatal leptospirosis
Published in Pathogens and Global Health, 2020
Wan Shahriman Yushdie Wan Yusoff, Maha Abdullah, Zamberi Sekawi, Fairuz Amran, Muhammad Yazli Yuhana, Niazlin Mohd Taib, Anim Md. Shah, Syafinaz Amin Nordin
The clinical outcome of leptospirosis is highly variable. Most cases are mild, however, there are a significant number of patients with severe medical complications and even death. Mild leptospirosis symptoms include fever, headaches, and myalgia but a small percentage can manifest as conjunctival suffusion, meningitis, rash, jaundice, and renal insufficiency [5,6]. Leptospirosis may progress to Weil’s disease (severe form) exhibiting jaundice, acute renal failure and bleeding with a mortality rate exceeding 10%, or severe pulmonary hemorrhage syndrome (SPHS) with a mortality rate of more than 50% [7–9]. Variation in clinical outcomes has the potential to impede the diagnosis and management of leptospirosis cases. Leptospirosis disease screening uses rapid immunological tests and is confirmed either through a microscopic agglutination test (MAT) or Leptospira antigen detection by polymerase chain reaction (PCR) [10].
Epidemiology, clinical and laboratory findings of leptospirosis in Southwestern Greece
Published in Infectious Diseases, 2020
Despoina Gkentzi, Maria Lagadinou, Panagiotis Bountouris, Odyssefs Dimitrakopoulos, Christos Triantos, Markos Marangos, Fotini Paliogianni, Stelios F. Assimakopoulos
Table 2 shows the clinical findings and outcome of our cases. The most prevalent clinical feature was fever, which was present in 93.3% of patients, followed by headache (66%), hematuria (31.1%), conjunctival suffusion and hepatomegaly (26.6%), dyspnoea, tachypnea, and splenomegaly (17.7%). Arthralgias and oliguria were infrequently recorded (2.2%). One patient was admitted to the Intensive Care Unit with severe respiratory insufficiency owing to pulmonary hemorrhage with a fatal outcome and one patient was supported with renal replacement therapy with gradual normalization of renal function.