Clinical and epidemiological profile of hospitalized patients with leptospirosis: a cross-sectional study in Durán, Ecuador, 2023

Abstract

Introduction Leptospirosis is a globally distributed zoonosis, particularly prevalent in tropical and subtropical regions, with epidemic potential during the rainy season. It is caused by pathogenic Leptospira species and produces a wide clinical spectrum, ranging from mild febrile illness to severe, life-threatening disease. Objective To describe the clinical and epidemiological characteristics of hospitalized patients with serologically supported leptospirosis in Durán, Guayas province, Ecuador. Methods A descriptive, cross-sectional study was conducted at the Hospital General Dr. Enrique Ortega Moreira between January and June 2023. Patients aged 15 years or older with fever and positive IgM serology for leptospirosis were included. Data were obtained from anonymized medical records. Categorical variables were summarized as frequencies and percentages, and continuous variables as medians with interquartile ranges (IQR). Group comparisons used the Pearson chi-square or Fisher exact test for categorical variables and the Mann–Whitney U test for continuous variables. Results Forty-eight patients met the inclusion criteria. Most were male (58.3%) and aged 15–39 years (85.5%). The most frequent symptoms were fever (93.8%) and diarrhea (83.3%). The median duration of fever was 17 days (IQR 8–21), reaching up to 60 days. Concurrent dengue IgM positivity was identified in 22.9% of patients and was associated with a longer median fever duration (19 vs 16 days; p=0.036). Frequent laboratory abnormalities included hypoalbuminemia (86.4%), hyponatremia (82.9%), hypokalemia (55.3%), thrombocytopenia (54.2%), and anemia (54.2%). The median hospital stay was 7 days (IQR 5–8). Conclusions Hospitalized leptospirosis cases in Durán during the 2023 rainy season showed frequent gastrointestinal manifestations, laboratory abnormalities, prolonged fever, and substantial dengue IgM positivity. These findings highlight diagnostic challenges in endemic coastal settings and support the need for strengthened surveillance, systematic evaluation of co-circulating infections, and national clinical practice guidelines for leptospirosis.