A leptospirose ocorre predominantemente em pacientes jovens do
gênero masculino.
As principais manifestações clínicas incluem febre, mialgia, icterícia,
cefaleia, vômitos, desidratação, calafrios, dor na panturrilha, diarreia e manifestações hemorrágicas.
As principais alterações laboratoriais incluem perda de função renal,
com elevação de ureia e creatinina, alterações hepáticas, com elevação das enzimas hepáticas, elevação de bilirrubinas, alterações hematológicas, sobretudo anemia e plaquetopenia e alterações da coagulação, com alargamento do tempo de ativação da protrombina.
A prevalência de LRA à leptospirose é alta, com a maioria dos
pacientes já apresentando LRA à admissão hospitalar.
Existe associação significativa das classificações RIFLE e AKIN com a
mortalidade em pacientes com LRA secundária à leptospirose.
O uso de penicilina na leptospirose é benéfico, estando associado
principalmente à redução do tempo de internação, não sendo observado impacto na diminuição da mortalidade.
A diálise pode estar associada a redução da mortalidade, sobretudo
nos pacientes com LRA grave (RIFLE-F e AKIN 3).
Os fatores associados a maior mortalidade na leptospirose foram
classificações RIFLE-F, AKIN 3 e necessidade de diálise.
As classificações RIFLE e AKIN foram semelhantes na leptospirose,
R
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