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LeptospirosisAka: Leptospira, Leptospira interrogans, Weil's Disease

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  1. Pathophysiology
    1. Fresh-waterborne Spirochete
    2. Transmission: Passed via infected animals urine
    3. Penetrates mucus membranes, broken skin, Conjunctiva
  2. Risk Factors
    1. Water activity in endemic areas (Hawaii, malaysia)
    2. Fresh-water related activities
      1. Farming or gardening
      2. Hiking across streams
      3. Swimming
      4. Rafting
      5. Spelunking
  3. Symptoms and signs
    1. Follows 7-12 day incubation
    2. Anicteric Leptospirosis (90% of cases)
      1. Phase 1: Initial septicemic phase (lasts 3-7 days)
        1. Headache
        2. High fever
        3. Myalgia
        4. Conjunctivitis
        5. Maculopapular rash
        6. Hepatomegaly
        7. Splenomegaly
      2. Phase 2 (follows brief improvement from phase 1)
        1. Meningitis
        2. Uveitis
        3. Chorioretinitis
    3. Icteric Leptospirosis (Weil's Syndrome, 10% of cases)
      1. Much more severe than anicteric form
      2. Fever
      3. Jaundice
      4. Azotemia
      5. Hypotension
      6. Hemorrhagic Vasculitis
  4. Labs
    1. Start empiric therapy if Leptospirosis suspected
      1. Do not wait for diagnostic tests
    2. Serology
      1. Acute phase serum 1-2 weeks after illness onset
      2. Convalesent serum 3-4 weeks after illness onset
    3. Culture (Growth may require 16 weeks)
      1. Blood Culture
      2. Urine Culture
      3. Cerebrospinal Fluid Culture
  5. Management
    1. Consider empirical treatment if suspected
    2. Antibiotics
      1. Doxycycline
      2. Penicillin (IV in severe cases)
  6. Prevention
    1. Doxyxycline prophylaxis if high risk of exposure
  7. References
    1. Tappero in Mandell (2000) Infectious Disease p. 2495
    2. Joyce (2002) Prim Care 29(4):971
    3. Lo Re (2003) Am Fam Physician 68(7):1343

Leptospira (C0023358)

Definition (MSH)A genus of aerobic, helical spirochetes, some species of which are pathogenic, others free-living or saprophytic.
Definition (CSP)genus of aerobic, helical spirochetes, some species of which are pathogenic, others free-living or saprophytic.
ConceptsBacterium (T007)
EnglishGenus Leptospira, Leptospira
Spanishgénero Leptospira, genero Leptospira
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Leptospirosis (C0023364)

Definition (MSH)Infections with bacteria of the genus LEPTOSPIRA.
ConceptsDisease or Syndrome (T047)
ICD9100, 100.9
EnglishCane cutter's fever, Harvest fever, Infection due to Leptospira, Japanese autumnal fever, Leptospiroses, Leptospirosis, Mud fever, Queensland fever, Red water fever, Spirochaetal jaundice, Spirochetal jaundice, Swamp fever
Spanishenfermedad de los trabajadores de los campos de arroz, fiebre de los pantanos, fiebre de Queensland, infección por Leptospira, infeccion por Leptospira, leptospirosis
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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