STEVEN J. BERMAN, M.D.; CHE-CHUNG TSAI, D.V.M.; KING HOLMES, M.D., Ph.D.; JAMES W. FRESH, M.D.; RAYMOND H. WATTEN, M.D.
Leptospiral infections were a common cause of acute fever among American servicemen in Vietnam. In 150 men the clinical illness was characterized by the abrupt onset of fever, chills, and headache; myalgias and gastrointestinal complaints were common. The most characteristic physical findings were muscle tenderness (42%) and conjunctivitis (42%). Aseptic meningitis occurred in nine patents. Oliguria and azotemia of renal origin occurred in seven patients, but none required dialysis. Only two patients became jaundiced; however, some liver function tests were abnormal in 40% of the patients. There were no deaths. The clinical diagnosis depended on recognizing the syndrome of muscle tenderness, conjunctivitis, and gastroenteritis in a febrile patient from an endemic area. One third of the patients had no abnormal findings other than fever, and the leptospiral infection would not have been detected without serological surveillance of febrile patients from endemic areas.
BERMAN SJ, TSAI C, HOLMES K, FRESH JW, WATTEN RH. Sporadic Anicteric Leptospirosis in South Vietnam: A Study in 150 Patients. Ann Intern Med. ;79:167–173. doi: 10.7326/0003-4819-79-2-167
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Published: Ann Intern Med. 1973;79(2):167-173.
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