Epidemiology, clinical and laboratory findings of leptospirosis in Southwestern Greece.

Background: Leptospirosis is a zoonosis with global distribution. The aim of the present study was to determine epidemiological, clinical and laboratory characteristics of leptospirosis in Greece.Methods: We retrospectively reviewed the clinical and laboratory profile as well as the outcome of all adults with confirmed leptospirosis in our Tertiary Referral centre in Southwestern Greece from 2013 to 2017.Results: Thirty-one men and fourteen women (mean age: 55.5 ± 13.8 years), were diagnosed with leptospirosis based on compatible clinical course and positive serology for IgM antibodies. Thirty-two (71.1%) lived in rural areas and the majority of infections (88.8%) were autochthonous, acquired in Southwestern Greece. Eighteen patients (40%) reported occupational exposure. The most prevalent clinical feature was fever (93.3%), followed by headache (66%), hematuria (31.1%), conjunctival suffusion and hepatomegaly (26.6%), dyspnoea, tachypnoea and splenomegaly (17.7%). One patient died due to pulmonary hemorrhage. Increased CRP (median 19 mg/dL) was the most common laboratory abnormality detected (93.3%), followed by thrombocytopenia (80%), increased aminotransferases (AST in 73.3% and ALT in 66.6%), anemia (66.6%) and hematuria (>100 RBC per high power field) in 66.6%. Empiric treatment with at least one active antibiotic against Leptospira was administered in 40 patients (88.8%).Conclusions: We found a higher disease incidence in our area compared to previous reports in Greece. Clinical signs of leptospirosis are diverse and generally nonspecific. Further epidemiological studies conducted ideally at a national level are required to determine the true disease incidence and better understand risk factors associated with unfavorable outcomes.