Pulmonary involvement in leptospirosis

The objective of this study was to assess the incidence of pulmonary involv ement in a cohort of 26 patients in whom a diagnosis of leptospirosis had b een made. Seventeen of the 26 patients had respiratory symptoms, Of these 1 7 patients, 13 had radiographs showing pulmonary abnormality. The most freq uent finding was a bilateral patchy alveolar-acinar pattern in six patients . Three patients developed acute respiratory distress syndrome and died due to multiorgan failure. Only cigarette smoking was significantly associated with respiratory involvement (odds ratio, 19.2; 95% CI, 1.7-250: P < 0.001 ), The results indicate that pulmonary manifestations are observed in a hig h percentage of patients with leptospirosis. Cigarette smoking is a risk fa ctor for the development of pulmonary involvement in human leptospirosis.