Long pentraxin PTX3 is associated with mortality and disease severity in severe Leptospirosis

J. F P Wagenaar, M. G A Goris, M. Hussein Gasem, Bambang Isbandrio, Federica Moalli, Alberto Mantovani, Kimberly R. Boer, Rudy A. Hartskeerl, Cecilia Garlanda, E. C M van Gorp

Research output: Contribution to journalArticlepeer-review


Objective: To evaluate the long pentraxin PTX3 in patients with severe leptospirosis and to compare the results with the widely used short pentraxin C-reactive protein and the pro-inflammatory cytokines IL-6 and IL-8. Methods: This observational cohort study was carried out in Semarang, Indonesia, where leptospirosis is endemic and mortality is high. Consecutive patients with severe leptospirosis were sampled on admission and during follow-up. Results: A total number of 52 patients entered the study, the mortality was 27%. Severe leptospirosis patient yielded elevated plasma PTX3 levels. PTX3 correlated with IL-8 and to a lesser extent with CRP and IL-6 levels. High levels of PTX3, IL-6 and IL-8 were associated with mortality (OR 5.6, 95%CI: 1.2-26; OR 3.2, 95%CI: 1.2-8.1; OR 6.5, 95%CI: 1.5-28). Moreover, PTX3 levels were associated with disease severity (OR 9.5; 95%CI: 2.9-45). This association was unique, since none of the other markers showed this relation. C-reactive protein was not able to differentiate the severe from the severest cases. Conclusions: The long pentraxin PTX3 is elevated in patients with severe leptospirosis and is associated with fatal disease and disease severity. PTX3 may be used as a marker to monitor disease severity in severe leptospirosis or predict outcome.

Original languageEnglish
Pages (from-to)425-432
Number of pages8
JournalJournal of Infection
Issue number6
Publication statusPublished - Jun 2009


  • Inflammation
  • Innate immunity
  • Leptospira
  • Leptospirosis
  • PTX3 protein
  • Sepsis

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)


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