Study of Decreasing Kinetics of the Leptospiremia During Antibiotic Treatment of Leptospirosis in Martinique
Study of Decreasing Kinetics of the Leptospiremia During Antibiotic Treatment of Leptospirosis in Martinique
The leptospirosis evolves on an endemic mode in French West Indies and its incidence in 2011
 was de 61/100 000 inhabitants, 100 times more than the metropolitan France's incidence
 (0,47/100 000). If cases can arise all year long, periods of heavy rainfall are associated
 with the arisen of epidemic peaks Clinical presentation of leptospirosis include a wide range
 of symptoms: the most frequent form is a flu-like syndrome but more severe forms are
 described as meningitis, uveitis and classical severe presentation such as lung bleedings and
 liver-kidneys infringement (syndrome of Weil) which constitute the most severe forms of the
 disease.

 Currently , Polymerase chain reaction (PCR) is the only test who can provide a diagnostic
 confirmation during the first week of development and before the appearance of the first
 antibody.

 If the microagglutination test (MAT) is considered the gold standard test for diagnosis of
 leptospirosis. However it requires rending samples to the referent National center for the
 leptospirosis at Pasteur Institute in Paris while the antibodies do not appears until the
 second week of illness. A second sample is required 15 days after the first one, to confirm
 the diagnosis.

 In clinical practice , the technique of real-time PCR for the detection and quantification of
 pathogenic Leptospira during the first week of illness . The technique of diagnosis of
 leptospirosis by real-time PCR has been implemented and tested in 2007 at the University
 Hospital of Martinique and providing to the clinicians from 2008. The optimal duration of
 antibiotic therapy has not been studied and experts now recommend for a 7 to 10 days,
 regardless of the severity of the disease. The evolution of leptospiremia treated patients
 has not been studied to date.
Inclusion Criteria:

 -  Adults ( more than 18 years)

 -  Diagnosis of leptospirosis confirmed by PCR in the five first day

 -  Appeal to one of the hospital departments participating in the research: in emergency
 room, in complete hospitalization

 -  Affiliated patients or beneficiaries of a national insurance scheme

 -  Acceptance to participate in the study and in the proposed follow-up, and signature of
 the consent signed by the person or by his(her) representative

 Exclusion Criteria:

 -  Test of negative PCR

 -  Children under age 18

 -  No possible follow-up after the first visit

 -  Pregnant patient

 -  Refusal of participation in the study

 -  Unaffiliated patients or beneficiaries of a national insurance scheme.