Leptospirosis

This critter is the commonest cause of leptospirosis.

Definition

Infection caused by Leptospira interrogans.

Epidemiology

Pretty rare, but worth knowing about.

Pathophysiology

Passed in urine of small mammals, so generally comes from swimming or working in fresh water. Classic history, someone will be swimming, sailing or canoeing in a lake, a week later gets ill.

Clinical Features

Two phases:

Acute phase

• Classic acute viral infection
• Fever
• Joint pain
• Headache

Second phase

Also known as Weil's disease, this is much more serious. Approximately 5-10% of acute go on to get this.

• Jaundice
• Liver failure
• Renal failure
• Meningitis
• Haemorrhage
• Death

Investigations

Leptospires seen on dark ground microscopy of blood.

Management

Doxycycline and Benzylpenicillin

Prognosis

Treated early, most respond well. Obviously, if you have renal failure, liver failure, meningitis and you are bleeding out of your eyes, things are looking less good.