Hematological and Biochemical Changes in Leptospirosis Patients: A Case Series

Abstract

Introduction: Leptospirosis is a zoonotic bacterial disease prevalent in Sri Lanka with significant hematological and biochemical presentations. Early diagnosis is hindered by the lack of confirmatory investigations, hence Full Blood Count (FBC), Renal Function Tests (RFT), and inflammatory markers are important in following disease status. The importance of FBC, RFT, and inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) is indeed crucial, particularly in resource-constrained environments. They are inexpensive and easily accessible and provide critical information for early diagnosis of the disease and control of conditions such as leptospirosis. Early management of hematological and biochemical derangements is of utmost importance since it can significantly decrease morbidity and mortality. The current study analyzes hematological and biochemical patterns in leptospirosis patients to identify prognostic markers. Methods: Retrospective case series was conducted in six patients with confirmed leptospirosis in a tertiary care facility. Serial white blood cell (WBC) counts, hemoglobin (HGB), platelet count, serum creatinine, blood urea nitrogen (BUN), CRP, and ESR were compared. Statistical correlation between platelet recovery, renal function improvement, and resolution of inflammatory markers was assessed. Results: The common trends included an initial leukocytosis, worsening thrombocytopenia, renal impairment, and elevated CRP and ESR. Severe presentations involved worsening thrombocytopenia and renal function requiring intensive care. Statistical analysis revealed  platelet recovery and improvement in renal function to be highly correlated (r = 0.85, p < 0.01) and resolution of inflammatory markers to be highly correlated with clinical outcome (r = 0.77, p < 0.05). Discussion: This study underscores the prognostic significance of serial haematological and biochemical monitoring in leptospirosis. FBC, RFT, CRP, and ESR are inexpensive tools in resource-limited settings for risk stratification and early management of the disease. Conclusion: Routine monitoring of hematological and biochemical parameters is necessary to assist in challenging clinical decisions regarding leptospirosis, improve patient outcomes, and better use scarce resources in endemic areas.