Leptospirosis history and symptoms: Difference between revisions
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* Jaundice | * Jaundice | ||
* Conjunctival suffusion a pathognomic of leptospirosis | * Conjunctival suffusion a pathognomic of leptospirosis | ||
===Other Symptoms=== | |||
* [[Chills]] | * [[Chills]] | ||
* [[Red eyes]] | * [[Red eyes]] | ||
* [[Abdominal pain]] | * [[Abdominal pain]] | ||
* [[Diarrhea]] | * [[Diarrhea]] | ||
* [[Rash]] | * [[Rash]] | ||
===Acute Phase=== | ===Acute Phase=== | ||
* Also known as Septicemic phase or leptospiremic phase. | * Also known as Septicemic phase or leptospiremic phase. |
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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
Classic presentation of leptospirosis is a biphasic illness, and the onset of Symptoms within 2–30 days of exposure to the bacteria. Serious symptoms may manifest earlier on Days 4–6 of the illness depending on the type of pathogen and host immunological status.[1]
Symptoms
In humans, Leptospirosis can cause a wide range of symptoms, including:[2][3]
Common Symtoms
- Fever
- Headache
- Myalgia
- Nausea & vomitings
- Jaundice
- Conjunctival suffusion a pathognomic of leptospirosis
Other Symptoms
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.[4]
- 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.[5]
- 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.[6]
- 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%
Acute phase | Immune phase | |
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Anicteric leptospirosis | Icteric leptospirosis |
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References
- ↑ Faine, S (1982). Guidelines for the control of leptospirosis. Geneva Albany, N.Y: World Health Organization Obtainable from WHO Publication Centre USA. ISBN 924170067X.
- ↑ Heath CW, Alexander AD, Galton MM (1965). "Leptospirosis in the United States. Analysis of 483 cases in man, 1949, 1961". N Engl J Med. 273 (17): 915-22 concl. doi:10.1056/NEJM196510212731706. PMID 5319290.
- ↑ Perrocheau A, Perolat P (1997). "Epidemiology of leptospirosis in New Caledonia (South Pacific): a one-year survey". Eur J Epidemiol. 13 (2): 161–7. PMID 9084999.
- ↑ 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.