Leptospirosis is a zoonotic disease caused by the pathogenic Leptospira spp. The clinical presentations are diverse, ranging from undifferentiated fever to fulminant disease including meningeal forms. The neurological leptospirosis forms are usually neglected. The aim of this study was to investigate leptospirosis as the cause of aseptic meningitis using different diagnostic techniques including the polymerase chain reaction (PCR). Thirty-nine cerebrospinal fluid (CSF) samples from patients presenting with meningeal abnormalities, predominance of lymphocytes and negative results by traditional microbiological tests were processed by leptospiral culture, anti-leptospiral antibody response and PCR. Leptospira spp DNA was detected in 23 (58.97%) of the CSF samples. Anti-leptospiral antibodies were found in 13 (33.33%) CSF samples. Twelve CSF samples were positive by PCR assay and negative by microscopic agglutination test (MAT) assay. Two CSF samples were positive by MAT and negative by PCR. The positive and negative agreement between both tests was 11 and 14, respectively. CSF samples from six cases of unknown diagnosis were positive by PCR assay. Eight cases showed positive results using PCR and MAT. Leptospirosis could be detected by PCR assay from the 3rd-26th day after illness onset. The sensitivity of the PCR was assessed with confirmed cases of leptospirosis (by MAT) and found to be 89.5%. All CSFs were negative by culture. PCR was found to be a powerful tool for diagnosing meningitis cases of leptospirosis. We recommend that it may be used as a supplementary diagnostic tool, especially in the early stages of the disease, when other diagnostic techniques such as serology are not sensitive.

Avaliou-se a reação de contraimunoeletroforese (CIE) como teste gênero-específico para diagnóstico da leptospirose suína, usando-se três extratos solúveis de Leptospira sp, sorovares pomona, icterohaemorrhagiae e patoc, obtidos pelo tratamento com Triton X-100 a quente e aplicados a amostras de soro de suínos subdivididos em três grupos: Grupo 1, 10 suínos experimentalmente infectados com estirpe Pomona; Grupo 2, 50 suínos naturalmente infectados e Grupo 3, controle. As amostras de soros foram submetidas à reação de CIE e os resultados comparados aos da Soroaglutinação Microscópica (SAM), técnica de referência pela WHO. Os Grupos 1 e 3 foram monitorados por 93 dias após a inoculação (p.i.). Pela SAM a soroconversão do Grupo 1 ocorreu por volta do 10º dia p.i., enquanto pela CIE, empregando-se qualquer extrato antigênico, foi anterior à SAM. Quando a CIE foi realizada frente a antigeno homólogo à infecção, seus resultados foram equivalentes aos da SAM, não se verificando o mesmo frente aos antígenos heterólogos. Neste aspecto, os Grupos 1 e 3 mostraram comportamento diferente pois não houve diferença significativa entre os resultados da CIE frente aos três antígenos, o que poderia significar serem independentes do sorovar responsável pelo surto ou infectante. Embora a CIE seja segura, rápida, de fácil execução, de baixo custo e ideal para análise em grande escala de amostras, revelou-se de limitada capacidade gênero-específica, o que não é desejavel para testes de triagem de campo; mas poderia ser útil na detecção precoce de resposta sorológica em relação à SAM.

The Counterimmunoelectrophoresis reaction (CIE) was tested as a genus specific test for swine leptospirosis diagnosis using three soluble extracts obtained from Leptospira sp, serovars pomona, icterohaemorrhagiae and patoc. The extracts were treated with hot Triton X-100 and applied to serum samples of animals divided in three groups: Group 1, 10 swines experimentally infected with the Pomona strain; Group 2, 50 naturally infected swines and Group 3, 10 swines control. These animals were serologically evaluated by CIE and by the Microscopic Agglutination Test (MAT), the WHO reference technique. Groups 1 and 3 were monitored during a period of 93 days after infection (a.i.). Group 1 serum convertion took place around the 10th day a.i. by MAT but ocurred earlier by CIE using any antigen. When CIE was carried out with the homologous antigen to the experimental infection, the results were consistent with MAT, but not when the heterologous antigens were used. Groups 1 and 3 showed distinct results: in Group 3, diferences between results of CIE accomplished with any three antigen extracts were not significant, indicating lack of dependence on the serovar responsible for the outbreak. Although being safe, fast, easy to perform, inexpensive and ideal for analysis of large number of samples, CIE revealed limited genus specificity, which is not convenient for field screening tests. The advantage of CIE is the capability to detect antibodies earlier than MAT.

Um surto de leptospirose humana por atividade recreacional ocorreu no município de São José dos Campos em novembro de 1987, envolvendo um grupo de pessoas que, ao participarem de uma festa de confraternização em um clube na periferia da cidade, banharam-se em uma piscina de água natural. Após a realização da investigação epidemiológica e laboratorial, observou-se alta prevalência do sorotipo pomona na análise sorológica (91%) e não se conseguiu isolar o agente etiológico nas amostras de água da piscina do clube. Os dados epidemiológicos e laboratoriais sugerem que a fonte de infecção tenha sido a água da piscina contaminada por dejetos de suínos e de outros animais domésticos dos locais adjacentes a água do córrego que alimentava a piscina do clube.

An outbreak of human leptospirosis due to recreational activities ocurred at São José dos Campos, São Paulo, Brazil in November 1987. It involved a group of persons who had participated in a gathering in a suburb club which had a swimming pool fed with natural water. Epidemiological investigation was carried out and laboratorial tests from the patients were done. It was observed that a high prevalence of the pomona serotype (91%) was found in the serological analyses, while the presence of the agent of the infection could not be found in the water club swimming pool.

Dois grupos, constituídos de 43 esquistossomóticos hepato-esplênicos e 83 indivíduos controle, foram analisados quanto à prevalência de aglutininas anti-tifoídicas. Os esquistossomóticos apresentaram freqüência maior de aglutininas anti-tifoídicas (H e/ou O e/ou Vi) e de aglutininas anti-O do que os indivíduos "normais". Apesar de que estes dados se devam, pelo menos parcialmente, à maior exposição natural dos esquistossomóticos aos antígenos estudados, sugere-se não estar ocorrendo deficiência na síntese de anticorpos, hipótese esta freqüentemente associada às baixas taxas de positividade de anticorpos anti-O encontrados nestes pacientes com bacteremia prolongada pela Salmonella.

Antityphoid agglutinins in hepatosplenic Schistosomiasis patients (N = 43) and controls (N = 83) sera were measured. Higher antityphoid agglutinins (H and/or O and/or Vi) and higher anti-O agglutinin rate were observed in patients affected by Schistosomiais. Although a larger exposure to these antigens could have been responsible for the higher antibody rates observed in these patients, the agglutinin levels suggest there is in fact no deficiency in antibody synthesis, as has often been suggested to explain the low anti-O antibody rates found in chronic Salmonella bacteremia in patients with Schistosomiasis.

Dois grupos, constituídos de 43 esquistossomóticos hepato-esplênicos e 83 indivíduos controle, foram analisados quanto à prevalência de aglutininas anti-tifoídicas. Os esquistossomóticos apresentaram freqüência maior de aglutininas anti-tifoídicas (H e/ou O e/ou Vi) e de aglutininas anti-O do que os indivíduos "normais". Apesar de que estes dados se devam, pelo menos parcialmente, à maior exposição natural dos esquistossomóticos aos antígenos estudados, sugere-se não estar ocorrendo deficiência na síntese de anticorpos, hipótese esta freqüentemente associada às baixas taxas de positividade de anticorpos anti-O encontrados nestes pacientes com bacteremia prolongada pela Salmonella.

Antityphoid agglutinins in hepatosplenic Schistosomiasis patients (N = 43) and controls (N = 83) sera were measured. Higher antityphoid agglutinins (H and/or O and/or Vi) and higher anti-O agglutinin rate were observed in patients affected by Schistosomiais. Although a larger exposure to these antigens could have been responsible for the higher antibody rates observed in these patients, the agglutinin levels suggest there is in fact no deficiency in antibody synthesis, as has often been suggested to explain the low anti-O antibody rates found in chronic Salmonella bacteremia in patients with Schistosomiasis.