Human leptospirosis in patients with undifferentiated acute febrile illness in a tertiary care hospital in New Delhi

Background: Leptospirosis is an important cause of febrile illness with a widespread global distribution. Although endemic in the southern and western states of India, its true incidence in the northern states of the country remains underreported. The main objective of this study was to estimate the seropositivity of infections by Leptospira in patients presenting with undifferentiated acute fever, in a tertiary care hospital in New Delhi.Methods: This prospective observational study was conducted from November 2016 to March 2018 in a tertiary care hospital in New Delhi. Blood samples of the patients (n=370) having fever for more than one week and seronegative for typhoid, dengue, chikungunya and malaria were subjected to Leptospira IgM ELISA (DRG International Inc., USA). Data was analyzed using statistical software SPSS version 21.Results: Out of 370 patients, 142 (38.4%) were males and 228 (61.6%) were females; the mean age was 32.18 years. The most common symptom was headache (55.5%) and icterus (55.55%) whereas increased ALT/AST was the most common laboratory finding (88.8%) followed by anaemia (77.7%). On employing Leptospira IgM ELISA, 2.43% (9 cases, n=370) were strongly reactive (>1.0 OD) whereas 15.1% (56 cases) were weakly reactive (1.15-1.00 OD).Conclusions: There is a need to increase awareness and suspicion regarding diagnosis of leptospirosis. A positive IgM ELISA when correlated with patient’s clinical profile and epidemiological factors can aid in the timely diagnosis and treatment of these infections.