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tospirosis
Leptospirosis
– A z o o no sis caused by sp iro chetes o f the genus Leptospira, affecting m any d o m estic
and
wild anim als (p articularly ro d ents and p rincip ally rats).
– L ep to sp iro sis is acquired by ind irect co ntact (co ntact o f the sk in o r m uco us
m em branes
with anim al urine-co ntam inated water, e.g. when swim m ing) and less co m m o nly , by
d irect co ntact with infected anim als.
Clinical features
D iagno sis is d ifficult because o f th e bro ad sp ectrum o f clinical m anifestatio ns. A
d istinctio n is usually m ad e between the m ild fo rm (the m o st co m m o n, usually with a
favo urable o utco m e) and the severe fo rm (m ultip le o rgan d y sfunctio n sy nd ro m e).
– Mild form
• A fter an incubatio n p erio d o f o ne to 3 week s: influenz a- lik e illness ( h igh fever,
ch ills, h ead ach e, m y algias) , o ften co m bined w ith gastro intestinal d iso rd ers
( ano rexia, abd o m inal p ain, nausea, vo m iting) and p o ssible p ulm o nary signs
(co ugh, chest p ain). O ther signs: co njunctival haem o rrhage, hep ato sp leno m egaly ,
and m ultip le ad eno p athies. M ild jaund ice m ay be p resent, but this fo rm is usually
anicteric.
• T he signs regress after 5 to 6 d ay s, and then reap p ear, so m etim es with m eningeal
invasio n, which m ay be co m p licated by encep halitis o r m y elitis.
– Severe form or Weil's syndrome
T h e o nset o f th e d isease is th e sam e as in m ild fo rm . A fter a few d ay s, acute
h ep ato renal m anifestatio ns with fever, jaund ice, o ligo - anuric renal failure; d iffuse
h aem o rrh agic sy nd ro m e ( p urp ura, ecch y m o ses, ep istaxis etc.) , p ulm o nary signs
(co ugh, chest p ain, haem o p ty sis) and card iac signs (m y o card itis, p ericard itis).
! Temperature chart and progress of leptospirosis
Temperature!
40°
Azotemia!
Jaundice!
37°! days!
1! 5! 10! 15! 20!
Presence of leptospires!
In the blood!
In the CSF!
In the urine!
Presence of antibodies!
180
Leptospirosis
– A z o o no sis caused by sp iro chetes o f the genus Leptospira, affecting m any d o m estic
and
wild anim als (p articularly ro d ents and p rincip ally rats).
– L ep to sp iro sis is acquired by ind irect co ntact (co ntact o f the sk in o r m uco us
m em branes
with anim al urine-co ntam inated water, e.g. when swim m ing) and less co m m o nly , by
d irect co ntact with infected anim als.
Clinical features
D iagno sis is d ifficult because o f th e bro ad sp ectrum o f clinical m anifestatio ns. A
d istinctio n is usually m ad e between the m ild fo rm (the m o st co m m o n, usually with a
favo urable o utco m e) and the severe fo rm (m ultip le o rgan d y sfunctio n sy nd ro m e).
– Mild form
• A fter an incubatio n p erio d o f o ne to 3 week s: influenz a- lik e illness ( h igh fever,
ch ills, h ead ach e, m y algias) , o ften co m bined w ith gastro intestinal d iso rd ers
( ano rexia, abd o m inal p ain, nausea, vo m iting) and p o ssible p ulm o nary signs
(co ugh, chest p ain). O ther signs: co njunctival haem o rrhage, hep ato sp leno m egaly ,
and m ultip le ad eno p athies. M ild jaund ice m ay be p resent, but this fo rm is usually
anicteric.
• T he signs regress after 5 to 6 d ay s, and then reap p ear, so m etim es with m eningeal
invasio n, which m ay be co m p licated by encep halitis o r m y elitis.
– Severe form or Weil's syndrome
T h e o nset o f th e d isease is th e sam e as in m ild fo rm . A fter a few d ay s, acute
h ep ato renal m anifestatio ns with fever, jaund ice, o ligo - anuric renal failure; d iffuse
h aem o rrh agic sy nd ro m e ( p urp ura, ecch y m o ses, ep istaxis etc.) , p ulm o nary signs
(co ugh, chest p ain, haem o p ty sis) and card iac signs (m y o card itis, p ericard itis).
! Temperature chart and progress of leptospirosis
Temperature!
40°
Azotemia!
Jaundice!
37°! days!
1! 5! 10! 15! 20!
Presence of leptospires!
In the blood!
In the CSF!
In the urine!
Presence of antibodies!
180
