ArticlePLoS neglected tropical diseases2019
A simple score to predict severe leptospirosis.
Article in PLoS neglected tropical diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07127718 (Decreasing Leptospirosis Emergence Through Prognosis and Treatment Optimization), which is not on this map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Decreasing Leptospirosis Emergence Through Prognosis and Treatment Optimization (DeLEPTO) Project 1: Preventive Strategies for Early and Late Complications of Leptospirosis
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 58 citations in OpenAlex.
- The epidemiology and clinical features of rickettsial diseases in North Queensland, Australia: Implications for patient identification and management.PLoS neglected tropical diseases · 2019Pooled it
- Infection-associated acute kidney injury in resource-limited settings.Nature reviews. Nephrology · 2026Review
- Deciphering the "Doxycycline Deficiency Syndrome": Defining the Characteristic Clinical, Laboratory and Imaging Findings in Patients Presenting with Leptospirosis, Q Fever and Rickettsial Diseases in Far North Queensland, Tropical Australia.Tropical medicine and infectious disease · 2026Article
- Early diagnosis and treatment of leptospirosis: Optimizing clinical outcomes.The Journal of infection · 2026Review
- Spatiotemporal dynamics and environmental trends of reported human leptospirosis in Sri Lanka, 2007-2024.Frontiers in public health · 2026Article
- The Characteristics of Patients That Develop Severe Leptospirosis: A Scoping Review.Pathogens (Basel, Switzerland) · 2025Article
- Lung Involvement in Patients with Leptospirosis in Tropical Australia; Associations, Clinical Course and Implications for Management.Tropical medicine and infectious disease · 2025Article
- Evolution of human leptospirosis in French Guiana, 2016-2022.PLoS neglected tropical diseases · 2025Article
- Presentation and Clinical Course of Leptospirosis in a Referral Hospital in Far North Queensland, Tropical Australia.Pathogens (Basel, Switzerland) · 2025Article
- Predictors of severe leptospirosis: a review.European journal of medical research · 2025Review
- Leptospirosis.Nature reviews. Disease primers · 2025Review
- Review
- The Incidence, Aetiology and Clinical Course of Serious Infections Complicating Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drug Therapy in Patients with Rheumatoid Arthritis in Tropical Australia.Pathogens (Basel, Switzerland) · 2024Article
- Peripartum Infections: A Position Statement of the Indian Society of Critical Care Medicine.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- Analysing the outbreaks of leptospirosis after floods in Kerala, India.International journal of health geographics · 2024Article
- Case Report: Leptospirosis Complicated by Persistent, Bilateral Sensorineural Hearing Loss.The American journal of tropical medicine and hygiene · 2023Article
- Demographic and clinical risk factors associated with severity of lab-confirmed human leptospirosis in Colombia, 2015-2020.PLoS neglected tropical diseases · 2023Article
- 44-year-old Man with Hemoptysis and Hypoxemic Respiratory Failure: A Case Report.Clinical practice and cases in emergency medicine · 2023Article
- Development and validation of a simple machine learning tool to predict mortality in leptospirosis.Scientific reports · 2023Article
- Prognostic Factors for Leptospirosis Infection Severity.Tropical medicine and infectious disease · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe case-fatality rate of severe leptospirosis can exceed 50%. While prompt supportive care can improve survival, predicting those at risk of developing severe disease is challenging, particularly in settings with limited diagnostic support. METHODOLOGY/PRINCIPAL
findingsWe retrospectively identified all adults with laboratory-confirmed leptospirosis in Far North Queensland, Australia, between January 1998 and May 2016. Clinical, laboratory and radiological findings at presentation were correlated with the patients' subsequent clinical course. Medical records were available in 402 patients; 50 (12%) had severe disease. The presence of oliguria (urine output ≤500 mL/24 hours, odds ratio (OR): 16.4, 95% confidence interval (CI): 6.9-38.8, p<0.001), abnormal auscultatory findings on respiratory examination (OR 11.2 (95% CI: 4.7-26.5, p<0.001) and hypotension (systolic blood pressure ≤100 mmHg, OR 4.3 (95% CI 1.7-10.7, p = 0.002) at presentation independently predicted severe disease. A three-point score (the SPiRO score) was devised using these three clinical variables, with one point awarded for each. A score could be calculated in 392 (98%) patients; the likelihood of severe disease rose incrementally: 8/287 (3%), 14/70 (20%), 18/26 (69%) and 9/9 (100%) for a score of 0, 1, 2 and 3 respectively (p = 0.0001). A SPiRO score <1 had a negative predictive value for severe disease of 97% (95% CI: 95-99%). CONCLUSIONS/SIGNIFICANCE: A simple, three-point clinical score can help clinicians rapidly identify patients at risk of developing severe leptospirosis, prompting early transfer to referral centres for advanced supportive care. This inexpensive, bedside assessment requires minimal training and may have significant utility in the resource-limited settings which bear the greatest burden of disease.
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Registered trials
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