KETERLIBATAN MULTIORGAN PADA PENDERITA LEPTOSPIROSIS BERAT

Abstract

Backgrounds: Leptospirosis is the most widespread zoonosis in the world which caused by microorganism Leptospira interogans. Leptospirosis is systemic disease with multiple organ involvements especially in it severe form. Objective: The purpose of this research was to investigate the type and frequency of involved organs in severe leptospirosis patients. Methods: This was a cross sectional study. Research data was taken from SEALS (Semarang-Amsterdam Leptospirosis Studies) data. Samples of this research were patients included in research populations which fulfilled certain time span and completed inclusion criteria for signs and symptoms: fever > 38 ºC, calf pain, icteric, Acute Renal Failure (ARF), and positive LeptoTek Dri-Dot results that already confirmed by positive MAT (Microscopic Agglutination Test ). Result: Renal involvements in severe leptospirosis patients that could be detected by increased levels of urea 41 (57,7%), and increased levels of urea 34 (47,9%) and oliguria 18 (25,4%). Pulmonary involvements were found as ronchi 17 (23,9%) on physical examination; while through chest X-ray revealed the other images 7 (9,86%), signs of pneumonia 6 (8,45%), infiltrates images 2 (2,82%). Liver organ involvements could be detected through laboratories examination by elevation levels of SGOT 35 (49,3%), bilirubin total 26 (36,6%), SGPT 20 (28,2%), Gamma GT 17 (23,9%), Alkaline phosphatase 7 (9,9%). Last but not least, pancreas involvements could be detected through increased levels of amylase 1 (1,4%) and lipase 1 (1,4%). At last, complications of severe leptospirosis patients were death 6 (8,5%), shock 3 (4,23%), other bleeding site 3 (4,23%), ARDS (Adult Respiratory Distress Syndrome ) 2 (2,82%), pulmonary hemorrhage 2 (2,82%). Conclusions: In this research, the most organ that involved is renal (43, 67%). Furthermore according to be continued are liver (29, 58%), pulmo (7, 04%) and pancreas (1, 4%). Keywords: Severe leptospirosis, multiple organ