{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T18:42:51Z","timestamp":1710528171836},"reference-count":17,"publisher":"FapUNIFESP (SciELO)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Soc. Bras. Med. Trop."],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:p>INTRODUCTION: Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. METHODS: Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture). Test properties were determined for each cutoff number of the criteria from the case definition. RESULTS: Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8\u00b11.2 for confirmed leptospirosis and 5.9\u00b11.5 for non-leptospirosis patients (p&lt;0.0001). Best sensitivity (85.3%) and specificity (68.2%) combination was found with a cutoff of 7 or more criteria, reaching positive and negative predictive values of 90.1% and 57.7%, respectively; accuracy was 81.4%. CONCLUSIONS: The case definition, for a cutoff of at least 7 criteria, reached average sensitivity and specificity, but with a high positive predictive value. Its simplicity and low cost make it useful for rapid bedside leptospirosis diagnosis in Brazilian hospitalized patients with acute severe febrile disease.<\/jats:p>","DOI":"10.1590\/s0037-86822011000600016","type":"journal-article","created":{"date-parts":[[2012,1,7]],"date-time":"2012-01-07T07:04:22Z","timestamp":1325919862000},"page":"735-739","source":"Crossref","is-referenced-by-count":5,"title":["Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil"],"prefix":"10.1590","volume":"44","author":[{"given":"Alfredo Pereira Leite de","family":"Albuquerque Filho","sequence":"first","affiliation":[{"name":"Hospital Bar\u00e3o de Lucena"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e9ssica Guido de","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"Hospital Bar\u00e3o de Lucena"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inacelli Queiroz de","family":"Souza","sequence":"additional","affiliation":[{"name":"Hospital Bar\u00e3o de Lucena"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luciana Cardoso","family":"Martins","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Oswaldo Cruz"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta Iglis de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Oswaldo Cruz"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Jesu\u00edta Bezerra da","family":"Silva","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio Central de Sa\u00fade P\u00fablica Dr. Milton Bezerra Sobral"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulisses Ramos","family":"Montarroyos","sequence":"additional","affiliation":[{"name":"Universidade Federal de Pernambuco,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dem\u00f3crito de Barros","family":"Miranda Filho","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Oswaldo Cruz; Universidade Federal de Pernambuco,"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","series-title":"Human Leptospirosis: Guidance for diagnosis, surveillance and control","author":"Terpstra WJ","year":"2003"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1245","DOI":"10.1128\/CVI.00217-07","article-title":"Evaluation of four whole-cells leptospira-based serological tests for diagnosis of human leptospirosis","volume":"14","author":"Mcbride AJA","year":"2007","journal-title":"Clin Vaccine Immunol"},{"key":"ref3","first-page":"244","article-title":"Screening of patients with acute febrile illness for leptospirosis using clinical criteria and sorology","volume":"18","author":"Rao P","year":"2005","journal-title":"Natl Med J India","ISSN":"http:\/\/id.crossref.org\/issn\/0970-258X","issn-type":"print"},{"key":"ref4","first-page":"394","article-title":"Evaluation of clinical criteria for the diagnosis of leptospirosis","volume":"50","author":"Bal AM","year":"2002","journal-title":"J Assoc Physicians India","ISSN":"http:\/\/id.crossref.org\/issn\/0004-5772","issn-type":"print"},{"key":"ref5","first-page":"678","article-title":"Diagnosis of leptospirosis utilizing modified Faine's criteria (letter)","volume":"52","author":"Shivakumar S","year":"2004","journal-title":"J Assoc Physicians India","ISSN":"http:\/\/id.crossref.org\/issn\/0004-5772","issn-type":"print"},{"issue":"48","key":"ref6","article-title":"Evaluation of surveillance case definition in the diagnosis of leptospirosis, using the microscopic agglutination test: a validation study","volume":"9","author":"Dassanayake DLB","year":"2009","journal-title":"BMC Infect Dis"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1001\/jama.1994.03510330081039","article-title":"User's guide to the medical literature. III. How to use an article about a diagnostic test. 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