ΝΟΣΟΚΟΜΕΙΑΚΑ ΧΡΟΝΙΚΑ

ΝΟΣΟΚΟΜΕΙΑΚΑ ΧΡΟΝΙΚΑ, ΤΟΜΟΣ 72, TEYXOΣ 1−3, 2010 19Όσον αφορά τον ανθρώπινο εμβολιασμό, οι ερευνητι−κές προσπάθειες έχουν ναυαγήσει, καθώς λόγω τωνπολλαπλών οροτύπων που εμφανίζει η σπειροχαίτηείναι δύσκολη η παρασκευή του εμβολίου 22. Συνοψί−ζοντας, η νόσος του Weil αποτελεί μία ζωονόσο πουχαρακτηρίζεται από βαριά κλινική εικόνα και μεγάληθνητότητα (10−40%). Η έγκαιρη διάγνωση και αντιμε−τώπιση είναι ζωτικής σημασίας για την επιβίωση τουασθενούς.ΒΙΒΛΙΟΓΡΑΦΙΑ1. Speelman P: Λεπτοσπείρωση. In: Harrison,Εσωτερική Παθολογία, Kasper DL, Fauci SF, LongoDL, Braunwald E, Hauser SL, Jameson JL, Παρισιάνος16η έκδ. Αθήνα 2005.2. Meites E, Jay MT, Deresinski S et al: ReemergingLeptospirosis. Emerg Infect Dis 2004, 10: 406−412.3. Sehgal SC, Vijayachari P, Murhekar ΜV et al: Lepto−spiral infection among primitive tribes of Andamanand Nicobar Islands. Epidemiol Infection 1999, 122:423−428.4. Vijayachari P, Sugunan AP, Sharma S et al: Leptospi−rosis in the Andaman Islands, India. Trans R Soc TropMed Hyg 2008, 102: 117−122.5. Sehgal SC, Murhekar MV, Sugunan AP: Outbreak ofleptospirosis with pulmonary involvement in NorthAndaman. Indian J Med Res 1995, 102: 9−12.6. Sharma S, Vijayachari P, Sugunan AP et al: Serop−revalence of leptospirosis among high risk popula−tion of Andaman Islands, India. Am J Trop Med Hyg2006, 74: 278−283.7. Chawla V, Trivedi TH, Yeolekar ME: Epidemic ofleptospirosis: an ICU experience. J Assoc PhysiciansIndia 2004, 52: 619−622.8. Singh SS, Vijayachari P, Sinha A et al: Clinico−epi−demiological study of hospitalized cases of severeleptospirosis. Indian J Med Res 1999, 109: 94−99.9. Dall’Antonia M, Sluga G, Whitfield S et al: Lepto−spirosis pulmonary haemorrhage: a diagnostic chal−lenge. Emerg Med J 2008, 25: 51−52.10. Andrade L, De Francesco DE, Seguro AC: Leptospiralnephropathy. Semin Nephrol 2008, 28: 383−394.11. Pappachan MJ, Mathew S, Aravindan KP et al: Riskfactors for mortality in patients with leptospirosisduring an epidemic in northern Kerala. Natl Med JIndia 2004, 17: 240−242.12. Avdeeva MG, Moîsova DL, Kachanov AV: Bone mar−row hematopoiesis in leptospirosis and its role inanemia pathogenesis. Klin Lab Diagn 2003, 1: 38−40.13. Chidambaram N, Ramanathan M, Anandi V et al:Leptospirosis: clinical presentation and correlationwith serovars. J Commun Dis 2007, 39: 105−108.14. Serna JC, Ortiz JR, Servin AC et al: Seropositivityto leptospiras in sera from patients suspected ofviral hepatitis negative to serological markers. RevCubana Med Trop 2005, 57: 57−58.15. Sacramento E, Lopes AA, Costa E et al: Electrocar−diographic alterations in patients hospitalized withleptospirosis in the Brazilian city of Salvador. ArqBras Cardiol 2002, 78: 267−270.16. Dupont H, Dupont−Perdrizet D, Perie JL et al: Lep−tospirosis: prognostic factors associated with mor−tality. Clin Infect Dis 1997, 25: 720−724.17. Watt G, Padre LP, Tuazon ML et al. Placebo−con−trolled trial of intravenous penicillin for severe andlate leptospirosis. Lancet 1988, 1: 433−435.18. Panaphut T, Domrongkitchaiporn S, Vibhagool A etal: Ceftriaxone compared with sodium penicillin Gfor treatment of severe leptospirosis. Clin InfectDis 2003, 36: 1507−1513.19. Suputtamongkol Y, Niwattayakul K, Suttinont C et al:An open, randomized, controlled trial of penicillin,doxycycline, and cefotaxime for patients with severeleptospirosis. Clin Infect Dis 2004, 39: 1417−1424.20. McClain TB, Ballou WR, Harrison SM et al: Doxy−cycline therapy for leptospirosis. Ann Intern Med1984, 100: 696−698.21. Sehgal SC, Sugunan AP, Murhekar MV et al: Ran−domized controlled trial of doxycycline prophy−laxis against leptospirosis in an endemic area. Int JAntimicrob Agents 2000, 13: 249−255.22. Rodrνguez AG, Jimιnez YR, Santiesteban NB et al:Evaluation of the vaccine potentiality of 2 strainsfrom Leptospira interrogans serogroup Ballum. RevCubana Med Trop 2005, 57: 63−64.