Leptospirosis Flashcards
Where is Leptospirosis found?
Mainly Seychelles
Thailand, Hawai, Costa Rica
What is leptospirosis?
Bacteria called leptospirosis spread through urine of infected animals which can get into water or soil
Typically pigs, cattle, dogs, horses, rats and mice
What is the agent in leptospirosis?
Motile, Aerobic spirochetes
Survive weeks and days in soil-water
What is the pathogenesis of leptospirosis?
Causes mild liver necrosis, interstitial nephritis, tubular necrosis, muscle edema and pulmonary haemorrhage
What is the clinical presentation?
Mostly asymptomatic
Of the symptomatic illnesses, >90% are mild
Fulminant syndome: Weil’s disease
What are the stages of clinical course?
ANICTERIC LEPTO
First stage (septicemic): myalgia, headache, abdo pain, Conjunctival suffusion and fever
Second Stage (immune): Meningitis, uveitis, Rash and fever
ICTERIC LEPTO:
First stage (septicaemic)
Second stage immune
Both include symptoms of:
Jaudnice, haemorrage, renal failure and Myocarditis
Weil’s disease presentation?
Usually a single progressive illness, jaundice, renal failure, pulmonary involvement and haemorrhagic manifestations.
Can get Rash on skins (Fort Bragg Fever), Myocarditis and arrthymias, acute renal failure, sever myalgia and rhabdomyoliasis (high CK)
What do you see with the pulmonary involvement?
Bilateral ground glass opacities
Alevolar infiltrates and haemoptysis
What are the typical lab findings with poor prognosis?
Thrombocytopenia
Creatinine
Lactate
>1000 leptospires
How do you Dx
Dx with PCR
Can use MAT (Microscopic aaglutination test): measures antibodies, cannot distinguish between current and past infection
RDT
1st week diagnostics compared to 2nd week
1st week use conventional methods such as culture and dark field microscopy
2nd week use serological methods and lateral flow assays
tx of leptospirosis?
In severe disease use ceftriaxone, doxycycline can be used if this is not available
In mild to moderate disease use doxycycline
How can you prevent leptospirosis?
Immunise cattle
Reduce rodent population
Where is Leptospirosis common amongst travellers?
SE Asia!!
