ArticleBMC infectious diseases2019
Sequel and therapeutic modalities of leptospirosis associated severe pulmonary haemorrhagic syndrome (SPHS); a Sri Lankan experience.
Article in BMC infectious 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 23 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
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Pooled it
- Article
- Clinical Experience of Therapeutic Plasma Exchange (TPE) in Severe Leptospirosis: A Case Series from Sri Lanka.Tropical medicine and infectious disease · 2026Article
- Clinical presentation and laboratory findings: key indicators for early diagnosis and severity prediction of leptospirosis in Sri Lanka.BMC infectious diseases · 2026Article
- Leptospirosis.Nature reviews. Disease primers · 2025Review
- MicroRNA biomarkers and host response pathways in severe pulmonary hemorrhagic syndrome due to leptospirosis: A multi-omics study.The Journal of infection · 2025Article
- Bowel Necrosis in Leptospirosis: A Case Series of a Rare Complication.Case reports in infectious diseases · 2025Article
- Sequential pulmonary functions in survivors of leptospirosis pulmonary haemorrhage syndrome: a prospective cohort study.Tropical medicine and health · 2024Article
- Antibiotic Chemoprophylaxis for Leptospirosis: Previous Shortcomings and Future Needs.Tropical medicine and infectious disease · 2024Review
- An Insight Into Various Manifestations of Leptospirosis: A Unique Case Series From a State in Eastern India.Cureus · 2024Article
- Pulmonary haemorrhage as a frequent cause of death among patients with severe complicated Leptospirosis in Southern Sri Lanka.PLoS neglected tropical diseases · 2023Observational
- Global, regional, and country-level cost of leptospirosis due to loss of productivity in humans.PLoS neglected tropical diseases · 2023Article
- MPL36, a major plasminogen (PLG) receptor in pathogenic Leptospira, has an essential role during infection.PLoS pathogens · 2023Article
- Incidence of acute pancreatitis among patients with leptospirosis requiring extracorporeal membrane oxygenation (ECMO): a descriptive study.BMJ open gastroenterology · 2023Article
- Article
- A Scoring Tool to Predict Pulmonary Complications in Severe Leptospirosis with Kidney Failure.Tropical medicine and infectious disease · 2022Article
- Clinical characteristics and prognosis of patient with leptospirosis: A multicenter retrospective analysis in south of China.Frontiers in cellular and infection microbiology · 2022Article
- The relationship of oleic acid/albumin molar ratio and clinical outcomes in leptospirosis.Heliyon · 2021Article
- 12 Novel clonal groups of Leptospira infecting humans in multiple contrasting epidemiological contexts in Sri Lanka.PLoS neglected tropical diseases · 2021Article
- Predictors of Fatal Pulmonary Haemorrhage in Dogs Affected by Leptospirosis Approaching Haemodialysis.Veterinary sciences · 2021Article
Corrections and comments
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Authors and funding
11 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundThe emergence of leptospirosis-associated severe pulmonary hemorrhagic syndrome (SPHS) with high case fatality has been reported from many countries. Understanding of clinical disease and sequel of SPHS needs larger studies with adequate numbers. The purpose of this study was to describe the characteristics and sequel by different therapeutic approaches for SPHS in Leptospirosis in Sri Lanka.
methodsThis study was conducted at Teaching Hospital-Karapitiya (THK), Galle, Sri Lanka from June 2015 to December 2017. THK is the main tertiary care center for the Southern Province. All confirmed-cases of leptospirosis who presented during this period and were admitted to five medical units of THK were included in this study. SPHS was defined as a patient presenting; haemoptysis, arterial hypoxemia (Acute Lung Injury Score < 2.5), haemoglobin drop (10% from the previous value), or diffused alveolar shadows in the chest radiograph, without alternative explanation other than leptospirosis.
resultsOf the 128 MAT confirmed cases of leptospirosis, 111 (86.7%) had acute kidney injury (AKI) whilst SPHS was seen in 80 (62.5%). Patients typically developed SPHS within the first week of illness, mostly on days 4 and 5. The case fatality rate of this study sample was 28.1% (n = 36), while for patients with SPHS, it was 41.5%. Most of the deaths (n = 19) were within the first 3 days of admission (on the same day 8, and within next 48 h 11). Among SPHS patients, 59 received therapeutic plasma exchange (TPE). The survival rate was higher (n = 35, 74.5%) when the TPE was performed within the first 48 h of detecting SPHS compared to patients in whom the procedure was done after 48 h (n = 5, 54.5%). Of the 19 leptosprosis patients with SPHS who did not receive TPE, 17 died (89.5%). However, the group of patients who received TPE was primarily the patients survived beyond day 3.
conclusionsWe observed that during the study period, SPHS was common and the mortality rate was higher in the study area. The treatment modalities tested need further evaluation and confirmation.
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