Differential diagnosis of leptospirosis: summary of main clinical evidences

Abstract

Introduction: Leptospirosis is a serious clinical condition that manifests with pulmonary hemorrhage and acute kidney injury, leading to multiple organ failure in about 5 to 15% of cases. In situations where diagnosis is late and treatment is delayed, the mortality rate can reach about 50%. Identifying patients at risk of developing leptospirosis in its severe form is not easy for the clinician. Although laboratory and radiological support facilitates diagnosis, this is not a reality in low- and middleincome countries. Objective: To perform a literature review to highlight the main guidelines for the differential diagnosis of leptospirosis. Method: This is an exploratory study conducted in the PUBMED database, using the search strategy leptospirosis [title] AND diagnosis [title], including only clinical trials studies. Results: We included 10 articles in this review. Evidence Synthesis: Despite a number of effective laboratory methods for the diagnosis of leptospirosis, the use of scores based on clinical characteristics seems to be a promising way to make an early and assertive diagnosis, especially in places where health conditions are poor.