LEPTOSPIROSIS
Leptospirosis
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A common zoonotic disease
Caused by L.interrogans and L.biflexa
Rats –common hosts
Organism shed in the urine
Enters the body-skin/mucous
membrane
• Organs affected-kidney, liver, meninges,
brain
Clinical Features
 Age
group of 10-20 years;males
 Malaise, body pain, non specific
features of viral fever initially
 Conjunctival suffusion, tendernes in
calf and lumbar regions
 Headache, chills, anorexia and
jaundice
 Epigastric pain, tenderness and
vomiting
 Second
stage occurs after a week
 Common leptospiral
syndrome(CLS):20%
 CLS+ bleeding tendency:5%
 CLS+ meningitis:5%
 CLS+ involvement of liver, kidney,
lungs etc:70%
Other Manifestations
 Renal
failure
 Meningeal irritation
 Petechial haemorrhages from skin,
mucous membrane
 Myocarditis
 Hyptotension
 Multi organ failure
2 types of leptospirosis



Anicteric
Milder form
Fever, Myalgia,
Headache,
Conjunctival suffusion





90% patients present
with this form

Icteric(Weil’s
Syndrome)
Severe form
Jaundice +
involvement of other
organs
Oliguria, anuria,
proteinuria
5-10% have this type
Weils Syndrome
 Weils
syndrome can be defined as
severe leptospirosis with jaundice
accompanied by azotemia,
haemorrhage, anemia, disturbance in
consciousness and continued fever
 Hepato
renal syndrome
Complications
 Renal
failure
 Cardiac failure
 Respiratory failure
 Severe thrombocytopenia,
hemoptysis
 CNS involvement
 Pericarditis
Differential Diagnosis
 DHF
 Typhoid
fever
 Septicemia
 Pancreatitis
 Viral hepatitis
 Falciparum malaria
 Fulminant hepatic failure
Lab Diagnosis
 IgM
specific dot ELISA –sensitive and
specific
 MAT and slide agglutination testscreening
 Elevated
WBC count with neutrophilia
 Increaed
ESR (about 60mm)
 Serum
Bilirubin-mildy elevated
SGOT/SGPT-mildy elevated
High levels of CPK
Treatment
 Inj
Crystalline Penicilline 20 Lakh
units i.v 6th hourly
 Maintain adequate fluids and
hydration
 Doxycycline 100mg BD for 7 days
 Children-2
to 4 lakh units/kg of Inj.
CP for 7 days
Prevention
 Avoid
infection from animal sources
 Personal hygiene
 Disinfection of water sources
 Health Education
 Vaccination of animals and rodent
control