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Leptospirosis

Aka: Leptospirosis, Leptospira, Leptospira interrogans, Weil's Disease
  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):971-81
    3. Lo Re (2003) Am Fam Physician 68(7):1343-50

Leptospira (C0023358)

Definition (NCI) A genus of Gram-negative, aerobic, flexible, spiral-shaped, spirochete with internal flagella in the phylum Spirochaetes.
Definition (NCI) Any bacteria that is not assigned to the species level but can be assigned to the Leptospira genus level.
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.
Concepts Bacterium (T007)
MSH D007919
SnomedCT 26764003
English LEPTOSPIRA, Leptospira, NOS, Leptospiral, Leptospira (organism), Genus Leptospira (organism), 205 LEPTOSPIRA, Leptospira, leptospira, leptospiral, Leptospira Noguchi 1917 (Approved Lists 1980) emend. Faine and Stallman 1982, Genus Leptospira
Spanish género Leptospira, género Leptospira (organismo), Leptospira (organismo), Leptospira
Swedish Leptospira
Czech Leptospira
Finnish Leptospira
Russian LEPTOSPIRY, LEPTOSPIROZ, VOZBUDITELI, ЛЕПТОСПИРОЗ, ВОЗБУДИТЕЛИ, ЛЕПТОСПИРЫ
Polish Leptospira
French Leptospira
German Leptospira, Leptospiren
Italian Leptospira
Dutch Leptospira
Portuguese Leptospira
Sources
Derived from the NIH UMLS (Unified Medical Language System)


Leptospirosis (C0023364)

Definition (NCI) A contagious bacterial infection caused by spirochetes of the genus Leptospira. Humans are infected by contact with water and soil which have been contaminated with animal waste products. The signs and symptoms include an initial flu-like phase, followed by a second phase in which patients may develop meningitis, liver failure and renal failure.
Definition (MSH) Infections with bacteria of the genus LEPTOSPIRA.
Concepts Disease or Syndrome (T047)
MSH D007922
ICD9 100.9, 100
ICD10 A27, A27.9
SnomedCT 186953000, 187311001, 186959001, 77377001, 154391003, 266213004, 186958009, 50574007, 186954006
English Leptospiroses, Leptospirosis, LEPTOSPIROSIS, Infection due to Leptospira, NOS, Leptospirosis, NOS, Leptospirosis NOS, Leptospirosis, unspecified, Mud fever, [X]Leptospirosis, unspecified, leptospirosis, E-124 LEPTOSPIROSIS, leptospirosis (diagnosis), [X]Leptospirosis, unspecified (disorder), Leptospirosis NOS (disorder), Weil Disease, Leptospirosis [Disease/Finding], fort bragg fever, queensland fever, spirochaetal jaundice, leptospirose, swamp fever, leptospirosi, red water fever, mud fever, leptospiroses, Swamp fever, Red water fever, Cane cutter's fever, Harvest fever, Queensland fever, Rice-field worker's disease, Spirochaetal jaundice, Spirochetal jaundice, Japanese autumnal fever, Infection due to Leptospira, Leptospirosis (disorder), Queensland; fever, fever; Queensland, fever; mud, fever; swamp, leptospirosis, infection; leptospiral, leptospiral; infection, mud; fever, swamp fever; leptospirosis, swamp; fever, leptospirosis
Dutch leptospirosis, niet-gespecificeerd, Leptospira; infectie, Queensland; koorts, infectie; Leptospira, koorts; Queensland, koorts; modder, koorts; moeras, leptospirose, modder; koorts, moeras; koorts, leptospirose, moeraskoorts; leptospirose, Leptospirose, niet gespecificeerd, leptospirosis, Leptospirose
French Leptospirose, non précisée, Leptospirose, Infection à Leptospira, Infection à leptospires
German Leptospirose, unspezifisch, Leptospirose, nicht naeher bezeichnet, Leptospirose
Italian Leptospirosi non specificata, Leptospirosi
Portuguese Leptospirose NE, Leptospirose
Spanish Leptospirosis no especificada, Spirochetal jaundice, Rice-field worker's disease, Leptospirosis icterohemorrhagica, Spirochaetal jaundice, Pretibial fever, Seven day fever, Fort Bragg fever, Leptospirosis, Harvest fever, Red water fever, Japanese autumnal fever, Leptospirosis icterohaemorrhagica, Cane cutter's fever, Swamp fever, Queensland fever, Mud fever, [X]leptospirosis, no especificada (trastorno), [X]leptospirosis, no especificada, fiebre de los pantanos, enfermedad de los trabajadores de los campos de arroz, fiebre de Queensland, infección por Leptospira, leptospirosis (trastorno), leptospirosis, SAI (trastorno), leptospirosis, SAI, leptospirosis
Japanese レプトスピラ症, レプトスピラ症、詳細不明, ﾚﾌﾟﾄｽﾋﾟﾗｼｮｳｼｮｳｻｲﾌﾒｲ, ﾚﾌﾟﾄｽﾋﾟﾗｼｮｳ
Swedish Leptospiros
Czech leptospiróza, Leptospiróza, blíže neurčená, Leptospiróza
Finnish Leptospiroosi
Russian LEPTOSPIROZ, ЛЕПТОСПИРОЗ
Korean 상세불명의 렙토스피라증, 렙토스피라증
Croatian LEPTOSPIROZA
Polish Leptospiroza, Zakażenie Leptospira
Hungarian leptospirosis, Leptospirosis, nem meghatározott
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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