Abstract
BackgroundVisceral leishmaniasis (VL) is an important and potentially fatal neglected tropical disease. The aim of this study was to investigate hyponatremia and risk factors for death among VL patients.MethodsThis is a cross-sectional study with VL patients admitted to a tertiary hospital in Northeast Brazil, from 2002 to 2009. Patients were divided into two groups: non-survivors and survivors. Hyponatremia was defined as serum sodium < 135 mEq/L. A logistic regression model was done to investigate risk factors for death.ResultsA total of 285 VL patients were included, with mean age 37 ± 15 years, and 74% were males. Thirty-four patients died (11.9%). Non-survivors had a significantly higher prevalence of dyspnea (38.2 vs. 16.7%, p = 0.003), pulmonary crackles (11.8 vs. 4.0%, p = 0.049), dehydration (23.5 vs. 10.8%, p = 0.033), oliguria (8.8 vs. 0.8%, p = 0.001) and jaundice (47.1 vs. 14.3%, p < 0.001). They also presented higher prevalence of hyponatremia (41.9 vs. 24.1%, p = 0.035), thrombocytopenia (91.2 vs. 65.3%, p = 0.002) and severe hypoalbuminemia (78.3 vs. 35.3%, p < 0.001). In multivariate analysis, moderate/severe hyponatremia (OR = 2.278, 95% CI = 1.046–4.962), thrombocytopenia (OR = 5.482, 95% CI = 1.629–18.443), jaundice (OR = 5.133, 95% CI = 1.793–14.696) and severe hypoalbuminemia (OR = 6.479, 95% CI = 2.124–19.766) were predictors of death.ConclusionHigher prevalence of dehydration, oliguria, pulmonary symptoms and liver involvement was found in non-survivors VL patients. Hypoalbuminemia and hyponatremia were frequent and significantly associated with mortality.
Highlights
Visceral leishmaniasis (VL) is an important and potentially fatal neglected tropical disease
Moderate/severe hyponatremia (OR = 2.278, 95% confidence intervals (CI) = 1.046–4.962), thrombocytopenia (OR = 5. 482, 95% CI = 1.629–18.443), jaundice (OR = 5.133, 95% CI = 1.793–14.696) and severe hypoalbuminemia (OR = 6.479, 95% CI = 2.124–19.766) were predictors of death
Visceral Leishmaniasis (VL), known as kala-azar, is a zoonosis caused by protozoan parasites from the genus Leishmania, which are typically found in tropical areas
Summary
Visceral leishmaniasis (VL) is an important and potentially fatal neglected tropical disease. During the progression of the disease, the parasites affect reticuloendothelial tissues and important organs, such as lymph nodes, bone marrow, liver, spleen, digestive system and kidneys [3]. This condition predominantly affects children and young adults, and may manifest as an oligosymptomatic infection with non-specific symptoms such as low fever, dry coughing, sweating and malaise, or as a life-threatening chronic condition with pancytopenia, hemorrhagic phenomena, Daher et al BMC Infectious Diseases (2017) 17:168 hepatomegaly, splenomagly, hypoalbuminemia and elevated globulinemia [4, 5]
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