RESUMO
The hemorrhagic syndrome of leptospirosis was studied in guinea pigs. The study correlates hematological, histopathological and immunohistochemical alterations in sixty animals inoculated by the intraperitoneal route with 1ml of the culture of virulent strain of Leptospira interrogans serovar copenhageni. Leptospirae antigens were detected by immunoperoxidase, chiefly in liver, kidney and heart muscle capillaries. Possible pathogenic mechanisms responsible for hemorrhagic syndrome are discussed with emphasis on toxic and anoxic attacks causing damage to endothelia, platelet depletion and alterations to hemostasia rates: prothrombin time [PT], partial thromboplastin time [PTT] and fibrinogen concentrations. The clinical-laboratory picture is compatible with the histopathological observation of disseminated intravascular coagulation [DIC] in most of the guinea pigs from day 4 of infection.
Assuntos
Hemorragia/microbiologia , Leptospirose , Animais , Cobaias , SíndromeRESUMO
To study the pulmonary complications in leptospirosis case records of 23 such patients admitted at the Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brasil, were reviewed. Hemoptysis were seen in 21.7% and sputal blood in 30.4% of patients. Arterial gasometry detected hypoxemia and hypocapnia in most cases. Thoracic radiology showed an alveolar pattern in 60% of the patients, alveolo-interstitial in 20%, interstitial in 6%, and in 14% the lungs were considered to be normal. Necropsy of 13 cases showed edema, congestion and hemorrhage in the lungs in all cases. Hyaline membrane was found in 30% and fibrin thrombi in 46% of these cases, resulting in a diagnosis of adult respiratory distress syndrome and acute disseminated intravascular coagulation (consumption coagulopathy) in leptospirosis.
Assuntos
Leptospira interrogans serovar canicola , Leptospirose/diagnóstico , Pneumopatias/diagnóstico , Doença de Weil/diagnóstico , Adulto , Idoso , Anticorpos Antibacterianos/sangue , Feminino , Humanos , Leptospira interrogans/imunologia , Leptospira interrogans serovar canicola/imunologia , Leptospirose/complicações , Leptospirose/patologia , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pneumopatias/etiologia , Pneumopatias/patologia , Masculino , Pessoa de Meia-Idade , Radiografia , Doença de Weil/complicações , Doença de Weil/patologiaRESUMO
The authors discuss the microscopic changes in gastrocnemius muscle in Leptospirosis in 63 patients. The hyaline necrosis frequently associated to a hemorrhagic infiltrate represented the most important feature in the lesional picture of the disease. Other findings were swelling, loss of cross striations, vacuolation and regenerative changes of muscle fibres. This last one was represented by multinucleated sarcoblasts and the presence of thin and strongly basophilic new-formed fibres. Interstitial hemorrhage was frequently seen and an inflammatory afflux was only rarely observed. This histological picture was considered as characteristic and highly significant for the diagnosis of Leptospirosis.