Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- 161 Syphilis and Other Treponematoses
- 162 Lyme Disease
- 163 Relapsing Fever
- 164 Leptospirosis
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
164 - Leptospirosis
from Part XIX - Specific Organisms – Spirochetes
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- 161 Syphilis and Other Treponematoses
- 162 Lyme Disease
- 163 Relapsing Fever
- 164 Leptospirosis
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
Leptospirosis is an infection with spirochetes from the genus Leptospira. Infections are most commonly caused by Leptospira interrogans, of which more than 200 serovars infect humans. People become infected by exposure to animal urine or urine-contaminated surface water. Leptospira penetrate intact mucous membranes and abraded skin and disseminate widely via the bloodstream. Symptoms develop 7 to 12 days after exposure. Most patients have an abrupt onset of a self-limited, 4- to 7-day anicteric illness characterized by fever, headache, myalgias, chills, cough, chest pain, neck stiffness, and/or prostration (Table 164.1). An estimated 10% of patients will present with jaundice, hemorrhage, renal failure, and/or neurologic dysfunction (Weil's disease). The major clinical manifestations of disease result from infection of capillary endothelial cells leading to vasculitis (Table 164.2).
Classically, leptospirosis has been considered a biphasic illness. However, many patients with mild disease will not have symptoms of the secondary “immune” phase of illness, and patients with very severe disease will have a relentless progression from onset of illness to jaundice, renal failure, hemorrhage, hypotension, and coma. The illness is biphasic in about half of patients, with relapse occuring approximately 1 week after resolution of the initial febrile illness. A late complication is anterior uveitis, seen in up to 10% of patients months to years after convalescence. Leptospirosis in pregnancy is associated with spontaneous abortion but children with congenitally acquired leptospirosis have not been described to have congenital anomalies.
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- Information
- Clinical Infectious Disease , pp. 1139 - 1142Publisher: Cambridge University PressPrint publication year: 2008