{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:32:54Z","timestamp":1787031174862,"version":"build-2736575974"},"reference-count":32,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,14]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Leptospirosis represents a public health problem in Panama, with an incidence rate of 1 in 100,000 inhabitants in 2014. Despite active surveillance and reports of outbreaks in the news, publications about human leptospirosis in Panama are scarce. The objective of this study was to describe the epidemiological and clinical features of leptospirosis in a cohort of patients admitted to the national reference hospital from January 2013 to December 2018. A total of 188 patients with suspected leptospirosis were identified, but only 56.9% (107 of 188) of the medical records could be retrieved. Microagglutination assays were completed in 45% (48 of 107) of the patients, confirming leptospirosis in 29.2% (14 of 48) of the patients. The most prevalent serogroup identified was\n                    <jats:italic>Leptospira interrogans<\/jats:italic>\n                    icterohemorrhagiae (4 of 14, 28.6%). The majority of patients with confirmed disease were middle-aged (36.4 \u00b1 15.7 years), male (11 of 14, 78.6%), and symptomatic for 6.8 \u00b1 0.7 days before admission. The predominant clinical presentation was fever (13 of 14, 92.9%), abdominal pain (7 of 14, 50%), and jaundice (8 of 14, 57.1%). Respiratory failure (8 of 14, 57.1%), elevated creatinine levels on admission (8 of 14, 57.1%), transfusion of blood-derived products (6 of 14, 42.9%), and required use of vasopressors (4 of 14, 28.6%) were common complications. Mortality was 28.6% (4 of 14). Empiric antibiotic therapy was initiated in almost all patients (10 of 12, 83.3%), and was appropriate in 90% (9 of 10) of them. Our study highlights the high prevalence of severe disease and reveals the diagnostic challenges concealing the true burden of leptospirosis in Panama. However, the small number of confirmed patients limits the generalization of these findings.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.21-0851","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T08:26:12Z","timestamp":1668414372000},"page":"1261-1266","source":"Crossref","is-referenced-by-count":7,"title":["Leptospirosis: Epidemiological and Clinical Characteristics at the National Reference Hospital in Panama"],"prefix":"10.4269","volume":"107","author":[{"given":"Laia J.","family":"Vazquez Guillamet","sequence":"first","affiliation":[{"name":"William Crawford Gorgas Center for Geographic Medicine, University of Alabama at Birmingham, Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Belen","family":"Arauz","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Hospital Santo Tomas, Panama City, Panama;"},{"name":"Department of Medicine, University of Panama, Panama City, Panama;"},{"name":"National Research System, National Secretary of Research, Technology and Innovation, Panama City, Panama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A.","family":"Su\u00e1rez","sequence":"additional","affiliation":[{"name":"Gorgas Memorial Institute for Health Studies, Panama City, Panama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Gonz\u00e1lez","sequence":"additional","affiliation":[{"name":"Hospital Regional Nicolas A. Solano, La Chorrera, Panama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Domingo de Obald\u00eda","sequence":"additional","affiliation":[{"name":"Gorgas Memorial Institute for Health Studies, Panama City, Panama;"},{"name":"Hospital Aquilino Tejeira, Cocle, Panama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianik","family":"Moreno","sequence":"additional","affiliation":[{"name":"Gorgas Memorial Institute for Health Studies, Panama City, Panama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"German","family":"Henostroza","sequence":"additional","affiliation":[{"name":"William Crawford Gorgas Center for Geographic Medicine, University of Alabama at Birmingham, Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blas","family":"Armi\u00e9n","sequence":"additional","affiliation":[{"name":"National Research System, National Secretary of Research, Technology and Innovation, Panama City, Panama;"},{"name":"Gorgas Memorial Institute for Health Studies, Panama City, Panama;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Mandell, Douglas, and Bennett\u2019s Principles and Practice of Infectious Diseases","author":"Mandell","year":"2015"},{"key":"b2","series-title":"PLoS Negl Trop Dis","doi-asserted-by":"publisher","first-page":"e0003898","DOI":"10.1371\/journal.pntd.0003898","article-title":"Global morbidity and mortality of leptospirosis: a systematic review","volume":"9","author":"Costa","year":"2015"},{"key":"b3","year":"2011"},{"key":"b4"},{"key":"b5"},{"key":"b6"},{"key":"b7"},{"key":"b8"},{"key":"b9","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198402233100805"},{"key":"b10","series-title":"N Engl J Med","first-page":"497","article-title":"An efficacy trial of doxycycline chemoprophylaxis against leptospirosis","volume":"310","author":"Takafuji","year":"1984"},{"key":"b11","series-title":"Trop Geogr Med","doi-asserted-by":"publisher","first-page":"82","DOI":"10.4269\/ajtmh.1963.12.895","article-title":"A survey of the occurrence of leptospirosis in a dairy herd in the Republic of Panama","volume":"12","author":"Wolff","year":"1960"},{"key":"b12","series-title":"Am J Trop Med Hyg","doi-asserted-by":"publisher","first-page":"895","DOI":"10.4269\/ajtmh.1966.15.64","article-title":"Leptospires isolated in the Panama Canal Zone","volume":"12","author":"Gale","year":"1963"},{"key":"b13","series-title":"Am J Trop Med Hyg","doi-asserted-by":"publisher","first-page":"64","DOI":"10.4269\/ajtmh.18-0020","article-title":"An outbreak of leptospirosis among U. 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