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ISSN 1561-3194 (Electronic)

2015, Number 6

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Rev Ciencias Médicas 2015; 19 (6)

Features to be considered in the pathogenesis of human leptospirosis

García PRÁ, García OM, García OM

Language: Spanish
References: 37
Page: 1219-12930
PDF size: 484.93 Kb.


ABSTRACT

Introduction: a review of the pathogenesis of human leptospirosis was conducted, given the importance of the disease in Cuba due to its morbidity and mortality rates, endemism, with seasonal raising and occasional outbreaks, and the growth of deaths.
Objective: to update the pathophysiology for a better understanding of the clinical manifestations, contributing to timely therapeutic and early diagnosis of the disease.
Development: its pathogenesis is complex, with recently elucidated features. Harmful substances produced by the microorganism, initially hypothetical as the cytotoxic factor which damages the vascular endothelium causing vasculitis and hemolytic enzymes that damage the red cell membrane, which have been recently isolated. The importance of vascular endothelium in its pathogenesis, given by the capillary vasculitis, and the deposit in these circulating immune complexes, complemented by the amount of tissular damage, and the pathological activation of clotting mechanism due to the enhancement of the injured vascular endothelium. Microangiopathic hemolytic anemia was also reported in a patient with confirmed leptospirosis. The lack of vasculitis in patients, who died due to pulmonary hemorrhage, hypothesizes about the endothelial dysfunction as the cause of organ failure; reviewing the nonspecific inflammatory factors and neurological mechanisms in the pathogenesis of the disease.
Conclusions: the most important aspects reviewed are highlighted, contributing to the early diagnosis of the disease and its complications together with appropriate and timely therapeutic practices.


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