2. Academic Validation
  3. C-reactive protein: An easy marker for early differentiation between leptospirosis and dengue fever in endemic area

C-reactive protein: An easy marker for early differentiation between leptospirosis and dengue fever in endemic area

  • PLoS One. 2023 May 17;18(5):e0285900. doi: 10.1371/journal.pone.0285900.
Olivier Maillard 1 2,  David Hirschinger 3,  Samuel Bénéteau 1,  Yatrika Koumar 4,  Adrien Vague 5,  Rémi Girerd 5,  Laura DiAscia 3,  Julien Jabot 6,  Julien Cousty 7,  Andry Randrianjohany 8,  Antoine Bertolotti 2 4,  Loïc Raffray 9 10
Affiliations

Affiliations

  • 1 Department of Public Health and Research, CHU Réunion, Saint-Pierre, Reunion, France.
  • 2 Clinical Investigation Center, INSERM CIC 1410, CHU Réunion, Saint-Pierre, Reunion, France.
  • 3 Department of Emergency Medicine, CHU Réunion, Saint-Denis, Reunion, France.
  • 4 Department of Infectious Diseases, CHU Réunion, Saint-Pierre, Reunion, France.
  • 5 Department of Emergency Medicine, CHU Réunion, Saint-Pierre, Reunion, France.
  • 6 Intensive Care Unit, CHU Réunion, Saint-Denis, Reunion, France.
  • 7 Intensive Care Unit, CHU Réunion, Saint-Pierre, Reunion, France.
  • 8 Department of Internal Medicine, Groupe Hospitalier Est Réunion, Saint-Benoit, Reunion, France.
  • 9 Department of Internal Medicine, CHU Réunion, Saint-Denis, Reunion, France.
  • 10 UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Sainte-Clotilde, Reunion, France.
PMID: 37195992 DOI: 10.1371/journal.pone.0285900
Abstract

In tropical regions, leptospirosis and dengue fever (DF) are infectious diseases of epidemiological importance and have overlapping symptomatic features. The objective of this study was to identify the factors associated to diagnosing leptospirosis that differentiate it to DF at the initial hospital evaluation. A multicenter retrospective study was conducted comparing confirmed leptospirosis to DF cases. Clinical/laboratory findings were compiled at hospital admission on Reunion Island between 2018 and 2019. Multivariable logistic regression was used to identify the predictors of leptospirosis. In total, 98 leptospirosis and 673 DF patients were included with a mean age of 47.8 (±17.1) and 48.9 (±23.3) years, respectively. In the multivariate analyses, the main parameters associated with leptospirosis were: i) increased neutrophil counts, ii) C-reactive protein values, iii) the absence of prolonged partial thromboplastin time, and iv) a decrease of platelets. The most discriminating parameter was C-reactive protein (CRP). With a threshold of 50mg/L, CRP taken alone had a sensitivity of 94% and a specificity of 93.5%. The positive and negative likelihood ratios were 14.5 and 0.06, respectively. In the setting of an early presumptive diagnosis, we found that an increased CRP value (>50 mg/L) could help diagnose leptospirosis and aid the decision process for hospital surveillance and/or a potential Antibiotic treatment regimen.

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