Leptospirosis. Flashcards

1
Q

what is ETIOLOGY PATHOGEN of leptospirosis

A

Leptospira interrogans

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2
Q

what are the CHARACTERISTICS OF LEPTOSPIRA INTERROGANS?

EPIDEMIOLOGY !!!!!!!!!

A

group: spirochetes
obligatory aerobes
hook-shaped ends

common zoonotic disease worldwide and is most common in the TROPICS
ALSO hawaii

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3
Q

what are the RESERVOIRS FOR LEPTOSPIRA INTERROGANS?

A

rodents and livestock and dogs

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4
Q

what is the TRANSMISSION OF LEPTOSPIROSIS?

A

excretion of the bacteria with urine - contaminate the wet soil which in turn contaminates the water

we intake the agent through our skin / mucous membranes and aerosols

humans are accidental host - and play no role in transmission

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5
Q

who are at RISK FOR LEPTOSPIROSIS ?

A

channel construction worker, farm workers,

water sports enthusiasts

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6
Q

what is the INCUBATION PERIOD OF LEPTOSPIROSIS INTERROGANS ?

A

one-two week

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7
Q

what are the SYMPTOMS OF LEPTOSPIROSIS INTERROGANS ?

A

there is variable course of the disease : such as mild flu like symptoms , organ failure to death

mild form - characterized by nonspecific symptoms that generally resolve spontaneously after a week.
In some of cases, the disease progresses rapidly to a severe form (icterohemorrhagic leptospirosis, or Weil disease)

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it is biphasic

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1) mild form - 1 week
acute spike in fever , headache , joint and muscle pain
abdominal symptoms - D+V
redness of the conjuctiva and measles like exanthema
PHOTOPHOBIA

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mild leptospirosis resolve spontaneously - progress to the severe form (Weil disease)

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Severe leptospirosis (Weil disease, icterohemorrhagic leptospirosis) 

lasts 5-7 days
due to systemic spread and multiorgan involvement.

vasculitis of the capillaries - Hemorrhage
Purpura
Pulmonary hemorrhage → hemoptysis

organ involvement :
liver - hepatitis , jaundice , hepatomegaly , acute liver failure

kidney - acute renal failure , interstitial nephritis (hematurea , oligourea)

neuro = lymphocyte meningitis
cardio - myocarditis and pericarditis

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MORBUS WEIL - jaundice , splenomegaly and renal failure

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8
Q

what is the DIAGNOSIS OF LEPTOSPIROSIS INTERROGANS ?

A

Dark-field microscopy of urine or blood samples

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Serological tests :
1) Four-fold rise in the level of IgM titers within one month of the onset of symptoms
(ELISA )

2 )micro agglutination test - Positive one week after the onset of symptoms.

Patient serum is incubated with Leptospira serovars, and titers are obtained for serovars that react with patient serum.

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PCR: detect leptospiral DNA in bodily fluids

positive only during the bacteremic phase (i.e. within the first week of symptom onset).

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Urine cultures become positive after the first week.

Leptospira cultures require special media (Fletcher medium) and take weeks

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9
Q

TREATMENT OF LEPTOSPIROSIS ?

A

mild leptospirosis: doxycycline, azithromycin, or aminopenicillins (ampicillin, amoxicillin)

For severe leptospirosis
IV penicillin G,
doxycycline,
or 3rd generation cephalosporins (e.g., ceftriaxone)

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10
Q

what is the PREVENTION OF LEPTOSPIROSIS INTERROGANS ?

A

wear protective clothing

avoid contact between contaminated water and wound

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chemoProphylaxis against
leptospirosis: doxycycline

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Disease control: implement appropriate pest control, vaccination of livestock and pets

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