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Leptospirosis - Coggle Diagram
Leptospirosis
Epidemiology
Endemic throughout the world
Common in tropic regions
Peak incidence
Tropical regions
Rainy season
Temperate regions
Late summer-early autumn
Maintained by Chronic renal infection of carrier animals
Leptospires excreted in urine
Rats are the most common source
Infection
Direct contact with infected urine
Indirect contact through contaminated water/soil
Affects all ages
Mostly young adult men
Occupational exposure
Working with animals
Vets
Abattoir worker
Animal handlers
Working with potentially contaminated soil/water
Miners
Sewage workers
Rice farmers
Recreational exposure
Swimmers
Canoeists
Wind surfers
Diagnosis
Microscopy
Dark field microscopy
CSF
Urine
Silver and immunohistochemical stains
Tissues
Isolation of leptospires
Blood/CSF in first 10 days
Urine during 2nd/3rd week
Serology
ELISA
Macroscopic slide agglutination test
Microscopic slide agglutination test
4 fold rise in antibodies between acute and convalescent sera
PCR
Blood
CSF
Urine
Pathogenesis
Enters by...
Skin abrasions
Widespread haematagenous spread
Leptospiraemia disappears when antibody levels rise
Intact mucus membranes/conjunctiva
Incubation period: 5-14 days
Subclinical infection common
Biphasic course
Septicaemic/Acute phase
Immune/delayed phase
Clinical Manifestations
Aniceteric (90%) form
Septicaemic stage (5-7 days)
Acute onset high fever
Chills
Rigors
Headache
Severe myalgia
Conjunctival suffusion
Immune stage (4-30 days)
Aseptic meningitis
Renal impairment
Uveitis
Rash
Icteric (10%)/Weil's Disease
Hepatic/renal failure
Haemorrhagic pneumonitis
Myocarditis
Circulatory collapse
Treatment/Prevention
Treatment
Depends on severity
Start antibiotics immediately
Severe/moderately severe
Pencillin G
Ceftriaxone
Less severe
Doxycycline
Can also be used as a prophylaxis
Treat 7-14 days
Careful monitoring/support therapy
Prevention
Avoid high-risk exposures
Vaccination of livestock
Consistent rodent control
Appropriate protective measures
Disinfection of contaminated areas
