Leptospirosis classification: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 5: | Line 5: | ||
==Classification== | ==Classification== | ||
===Acute Phase=== | |||
* Also known as Septicemic phase or leptospiremic phase. | |||
* Begins abruptly | |||
* Bacteria are present in the blood and CSF of the patient | |||
* Characterized by wide spectrum of nonspecific signs and symptoms such as fever, chills, headache and conjunctival suffusion making it very difficult to diagnose.<ref name="pmid16333189">{{cite journal| author=Bal AM| title=Unusual clinical manifestations of leptospirosis. | journal=J Postgrad Med | year= 2005 | volume= 51 | issue= 3 | pages= 179-83 | pmid=16333189 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16333189 }} </ref> | |||
* Associate with severe myalgia | |||
* Other less common findings include: Photophobia, lymphadenopathy, abdominal pain, nausea, vomiting, a transient rash, sore throat, coughing or chest pain | |||
* Characterestic of this phase also includes: Mild form of leptospirosis in ~90% cases which lasts several days to a week, followed by a brief remission, during which the temperature drops and the symptoms disappear | |||
===Immune phase=== | |||
* It is also known as leptospiruric phase. | |||
* Circulating (IgM) antibodies are produced and leptospires are present in the urine | |||
* Characterestic findings that differentiate from other febrile illnesses are myalgia and conjunctival suffusion.<ref name="pmid22843698">{{cite journal| author=Forbes AE, Zochowski WJ, Dubrey SW, Sivaprakasam V| title=Leptospirosis and Weil's disease in the UK. | journal=QJM | year= 2012 | volume= 105 | issue= 12 | pages= 1151-62 | pmid=22843698 | doi=10.1093/qjmed/hcs145 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22843698 }} </ref> | |||
* Myalgia often involves in calf muscles, less commonly involves abdominal and para-spinal muscles. | |||
====Anicteric leptospirosis==== | |||
* More common but serious illness is uncommon | |||
* Most of cases present either subclinical or of very mild severity | |||
* Few cases present with a febrile illness of sudden onset | |||
* Other symptoms include chills, headache (severe with retro-orbital pain and photophobia), myalgia, abdominal pain, conjunctival suffusion, and skin rash (transient and last <24 hours) | |||
* May progress to aseptic meningitis in ≤25% of patients and more common in younger age group than the patients with icteric leptospirosis | |||
* Mortality is very less when compared to icteric leptospirosis | |||
====Icteric leptospirosis==== | |||
* Rapidly progressive and severe form of leptospirosis(Weil's disease) | |||
* In the severe form of leptospirosis renal failure, hepatic failure and pulmonary haemorrhage can occur and associate with Icterohaemorrhagiae.<ref name="pmid11692294">{{cite journal| author=Katz AR, Ansdell VE, Effler PV, Middleton CR, Sasaki DM| title=Assessment of the clinical presentation and treatment of 353 cases of laboratory-confirmed leptospirosis in Hawaii, 1974-1998. | journal=Clin Infect Dis | year= 2001 | volume= 33 | issue= 11 | pages= 1834-41 | pmid=11692294 | doi=10.1086/324084 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11692294 }} </ref> | |||
* Less common form of leptospirosis with incidence of 5%-10% | |||
* Jaundice is not associate with hepatocellular injury, eventually LFT returns to normal after recovery | |||
* High mortality rate with a range of 5%-15% | |||
==References== | ==References== | ||
Revision as of 16:01, 5 March 2017
|
Leptospirosis Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Leptospirosis classification On the Web |
|
American Roentgen Ray Society Images of Leptospirosis classification |
|
Risk calculators and risk factors for Leptospirosis classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]
Overview
Classification
Acute Phase
- Also known as Septicemic phase or leptospiremic phase.
- Begins abruptly
- Bacteria are present in the blood and CSF of the patient
- Characterized by wide spectrum of nonspecific signs and symptoms such as fever, chills, headache and conjunctival suffusion making it very difficult to diagnose.[1]
- Associate with severe myalgia
- Other less common findings include: Photophobia, lymphadenopathy, abdominal pain, nausea, vomiting, a transient rash, sore throat, coughing or chest pain
- Characterestic of this phase also includes: Mild form of leptospirosis in ~90% cases which lasts several days to a week, followed by a brief remission, during which the temperature drops and the symptoms disappear
Immune phase
- It is also known as leptospiruric phase.
- Circulating (IgM) antibodies are produced and leptospires are present in the urine
- Characterestic findings that differentiate from other febrile illnesses are myalgia and conjunctival suffusion.[2]
- Myalgia often involves in calf muscles, less commonly involves abdominal and para-spinal muscles.
Anicteric leptospirosis
- More common but serious illness is uncommon
- Most of cases present either subclinical or of very mild severity
- Few cases present with a febrile illness of sudden onset
- Other symptoms include chills, headache (severe with retro-orbital pain and photophobia), myalgia, abdominal pain, conjunctival suffusion, and skin rash (transient and last <24 hours)
- May progress to aseptic meningitis in ≤25% of patients and more common in younger age group than the patients with icteric leptospirosis
- Mortality is very less when compared to icteric leptospirosis
Icteric leptospirosis
- Rapidly progressive and severe form of leptospirosis(Weil's disease)
- In the severe form of leptospirosis renal failure, hepatic failure and pulmonary haemorrhage can occur and associate with Icterohaemorrhagiae.[3]
- Less common form of leptospirosis with incidence of 5%-10%
- Jaundice is not associate with hepatocellular injury, eventually LFT returns to normal after recovery
- High mortality rate with a range of 5%-15%
References
- ↑ Bal AM (2005). "Unusual clinical manifestations of leptospirosis". J Postgrad Med. 51 (3): 179–83. PMID 16333189.
- ↑ Forbes AE, Zochowski WJ, Dubrey SW, Sivaprakasam V (2012). "Leptospirosis and Weil's disease in the UK". QJM. 105 (12): 1151–62. doi:10.1093/qjmed/hcs145. PMID 22843698.
- ↑ Katz AR, Ansdell VE, Effler PV, Middleton CR, Sasaki DM (2001). "Assessment of the clinical presentation and treatment of 353 cases of laboratory-confirmed leptospirosis in Hawaii, 1974-1998". Clin Infect Dis. 33 (11): 1834–41. doi:10.1086/324084. PMID 11692294.