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more about Leptospirosis

Icterohemorrhagic Fever, Weil's Disease or syndrome

  • Leptospirosis refers to a group of infections that are caused by Leptospira bacteria. These include Weil's Disease, infectious jaundice, and canicola fever. In most cases, rats, dogs, cows, and pigs are the prime carriers of these bacteria.
  • The disease is transmitted to humans through food and water contaminated with the urine of affected animals (e.g., in a slaughterhouse). It may also be transmitted by bathing or working in contaminated water.

  • Less severe disease (though very uncomfortable) called "anicteric" (not associated with jaundice):
    • First phase
      1. High fever (102.2 to 104)
      2. Chills
      3. Body aches
      4. Severe headache
      5. Muscle pain (especially calves)
      6. Abdominal pain
      7. Eyes become red
      8. Then 1-3 days of improvement
    • Second phase
      1. Symptoms first phase reappear
      2. Eye pain
      3. Rash
      4. Enlarged lymph glands
  • Severe form ("icteric") called Weil's syndrome:
    1. Mental impairment
    2. Low Blood Pressure
    3. Kidney impairment
    4. Liver impairment (yellow skin and eyes)
  • Mild disease called pretibial fever:
    1. Fever
    2. Red patches on the skin of the lower legs
    3. Rash may be present

  • White blood cell count may be normal or up to 50,000/mL.
  • Urine may show bile, protein, red cells, or casts.
  • BUN and Creatinine (kidney functions tests) may be elevated.
  • Liver function tests may be elevated.
  • Creatinine Kinase is elevated in anicteric form.
  • Cerebral spinal fluid (spinal tap) may show organisms by dark field exam or special culture.
  • Urine cultures will also grow from day 10 until day 42.
  • Leptospira titers are elevated after 7 days.
  • Rapid IgM Elisa test

  • Penicillin intravenously or Doxycycline

  • Myocarditis (heart muscle inflammation)
  • Kidney failure
  • Massive bleeding
  • Aseptic Meningitis
  • Severe eye involvement

  • Seek immediate treatment. The more severe form (Weil's syndrome) can result in death in 1 in 20 afflicted individuals. Also, early treatment is best for all forms of this disease.

  • Doxycycline 200 mg once a week during risk of exposure

more about Leptospirosis

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