Severe Leptospirosis Features in the Spleen Indicate Cellular Immunosuppression Similar to That Found in Septic Shock

Conclusion: The results suggest that an immunosuppressive state develops at the terminal stage of severe leptospirosis with pulmonary hemorrhage and shock similar to that of patients with septic shock, with diffuse endothelial activation in the spleen, splenitis, and signs of disturbance in the innate and adaptive immunity in the spleen. The presence of leptospiral antigens in 73% of the spleens of the leptospirosis patients suggests the etiological agent contributes directly to the pathogenesis of the lesions. Our results support therapeutic approaches involving antibiotic and immunomodulatory treatments for leptospirosis patients and suggest that leptospirosis patients, which are usually young men with no co-morbidities, form a good group for studying sepsis and septic shock. Introduction Leptospirosis is the most widespread zoonosis in the world and is caused by pathogenic species of the Leptospira genus (1). In Brazil, leptospirosis is a re-emergent infectious disease with a growing incidence rate. In the city of São Paulo, the biggest Brazilian metropolis, leptospirosis had an incidence rate of 1.34-−2.73/100,000 inhabitants and a case-fatality of 8.86–15.61% in the period of 2009–2017 (2). The clinical presentations of leptospirosis range from a non-specific febrile illness to severe forms. Severe leptospirosis has an estimated incidence of 5–15% and patients can present jaundice, renal failure, myocarditis, meningitis, s...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research