Introduction
-Leptospirosis is a waterborne zoonosis of worldwide distribution, caused by spirochetes of the genus Leptospira
-it is excreted in urine of reservoir animals, especially rodents
-it is spread by animal urine contaminating lakes and streams
-Hawaii has the highest incidence in the United States
-Leptospira are tightly coiled, thin, flexible spirochetes, with very fine spirals, one end is often bent, forming a hook
-Human infection usually occurs often in bodies of water, entering the body through mucous membranes (mouth, nose, conjunctivae) and breaks in the skin (cuts and abrasions)
Symptoms & Signs
-Most human infections are asymptomatic and self-limited
-In symptomatic patients, Leptospirosis is a biphasic illness
Leptospiremic phase: fever,severe headache, chills, myalgias, hepatitis (with or without jaundice), nausea, vomiting, conjunctival injection without purulent discharge
Severe leptospirosis (Weil’s syndrome): hemorrhage, jaundice, acute renal injury, aseptic meningitis,uveitis, hepatic failure, renal failure, uveitis, rash, and circulatory collapse
Diagnosis
Serum agglutination tests are the primary diagnostic method
Other diagnostic aids: Dark-field examination, whole blood or urine culture
Treatment
Mild leptospirosis: Oral doxycycline, ampicillin or amoxicillin
Moderate or severe leptospirosis: intravenous penicillin, ampicillin, or ceftriaxone