LEPTOSPIROSIS Leptospirosis A common zoonotic disease Caused by

LEPTOSPIROSIS

Leptospirosis • 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 u Age group of 10 -20 years; males u Malaise, body pain, non specific features of viral fever initially u Conjunctival suffusion, tendernes in calf and lumbar regions u Headache, chills, anorexia and jaundice u Epigastric pain, tenderness and vomiting

u Second stage occurs after a week u Common leptospiral syndrome(CLS): 20% u CLS+ bleeding tendency: 5% u CLS+ meningitis: 5% u CLS+ involvement of liver, kidney, lungs etc: 70%

Other Manifestations u Renal failure u Meningeal irritation u Petechial haemorrhages from skin, mucous membrane u Myocarditis u Hyptotension u Multi organ failure

2 types of leptospirosis u Anicteric u u Milder form Fever, Myalgia, Headache, Conjunctival suffusion u u u 90% patients present with this form u Icteric(Weil’s Syndrome) Severe form Jaundice + involvement of other organs Oliguria, anuria, proteinuria 5 -10% have this type

Weils Syndrome u Weils syndrome can be defined as severe leptospirosis with jaundice accompanied by azotemia, haemorrhage, anemia, disturbance in consciousness and continued fever u Hepato renal syndrome

Complications u Renal failure u Cardiac failure u Respiratory failure u Severe thrombocytopenia, hemoptysis u CNS involvement u Pericarditis

Differential Diagnosis u DHF u Typhoid fever u Septicemia u Pancreatitis u Viral hepatitis u Falciparum malaria u Fulminant hepatic failure

Lab Diagnosis u Ig. M specific dot ELISA –sensitive and specific u MAT and slide agglutination testscreening

u Elevated WBC count with neutrophilia u Increaed u Serum ESR (about 60 mm) Bilirubin-mildy elevated SGOT/SGPT-mildy elevated High levels of CPK

Treatment u Inj Crystalline Penicilline 20 Lakh units i. v 6 th hourly u Maintain adequate fluids and hydration u Doxycycline 100 mg BD for 7 days u Children-2 to 4 lakh units/kg of Inj. CP for 7 days

Prevention u Avoid infection from animal sources u Personal hygiene u Disinfection of water sources u Health Education u Vaccination of animals and rodent control