Leptospirosis natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Natural history
In animals, the incubation period (time of exposure to first symptoms) is anywhere from 2 to 20 days. In dogs, the liver and kidney are most commonly damaged by leptospirosis. Vasculitis can occur, causing edema and potentially disseminated intravascular coagulation (DIC). Myocarditis, pericarditis, meningitis, and uveitis are also possible sequelae. [1] One should strongly suspect leptospirosis and include it as part of a differential diagnosis if the sclerae of the dog's eyes appear jaundiced (even slightly yellow), though the absence of jaundice does not eliminate the possibility of leptospirosis, and its presence could indicate hepatitis or other liver pathology rather than leptospirosis. Vomiting, fever, failure to eat, reduced urine output, unusually dark or brown urine, and lethargy are also indications of the disease.
In humans, leptospiral infection causes a wide range of symptoms, and some infected persons may have no symptoms at all. Leptospirosis is a biphasic disease that begins with flu-like symptoms (fever, chills, myalgias, intense headache). The first phase resolves and the patient is asymptomatic briefly before the second phase begins that is characterized by meningitis, liver damage (causing jaundice), and renal failure. Because of the wide range of symptoms the infection is often wrongly diagnosed. This leads to a lower registered number of cases than there really are. Symptoms of leptospirosis include high fever, severe headache, chills, muscle aches, and vomiting, and may include jaundice, red eyes, abdominal pain, diarrhea, and/or a rash. The symptoms in humans appear after a 4-14 day incubation period.
Complications
Complications include meningitis, respiratory distress and renal interstitial tubular necrosis, which results in renal failure and often liver failure (the severe form of this disease is known as Weil's disease, though it is sometimes named Weil Syndrome[2][3]). Cardiovascular problems are also possible. Approximately 5-50% of severe leptospirosis cases are fatal, however, such cases only constitute about 10% of all registered incidents.
References
- ↑ Heuter, Kerry J.,Langston, Cathy E. (2003). "Leptospirosis: A re-emerging zoonotic disease". The Veterinary Clinics of North America. 33: 791–807.
- ↑ Invalid
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- ↑ Weil syndrome definition - Medical Dictionary definitions of popular medical terms easily defined on MedTerms