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Leptospirosis/Weil’s disease

Leptospirosis/Weil’s disease

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Pathology

The most severe forms of leptospira species disease are caused by L. interrogans icterohaemorrhagiae. Natural hosts for this infection include rats, dogs, and farm animals, with an incubation period of 7 to 14 days.

Aetiology

The primary way of contracting leptospira species is through contact with water contaminated with rat urine, which may occur in activities such as sewers workers. Leptospires can survive in this environment for months.

Symptoms

  • Fever
  • Rigors
  • Headache with photophobia
  • Marked myalgia
  • Nausea

Icteric Disease (Weil's Disease): Further symptoms include jaundice, renal impairment, haemorrhage, systemic inflammatory response, or shock.

Signs

Conjunctival suffusion may also be present.

Investigations

The following tests may be utilized to diagnose leptospira species:

  • Full Blood Count (FBC)
  • Urea and Electrolytes (U&E)
  • Liver Function Tests (LFTs)
  • Mid Stream Urine (MSU) which may reveal proteinuria and casts.
  • Enzyme-Linked Immunosorbent Assay (ELISA)

Treatment

Treatment is mainly supportive in nature.

Complications

Complications may include chronic eye infection.

Prognosis

Excellent prognosis is expected for patients with mild forms of the infection, though the outcome is often poor for those with severe cases.

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