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Leptospirios- also known as Weil's disease, Weil's

syndrome, canicola fever, canefield fever, nanukayami


fever, 7-day fever, Rat Catcher's Yellows, Fort Bragg
fever, and Pretibial fever

>Leptospirosis is caused by a spirochaete bacterium


called Leptospira.
>Leptospirosis is transmitted by the urine of an infected
animal and is contagious as long as it is still moist.
>Humans become infected through contact with water, food,
or soil containing urine from these infected animals. This
may happen by swallowing contaminated food or water, or
through skin contact. The disease is not known to be spread
from person to person and cases of bacterial dissemination
in convalescence are extremely rare in humans.

The incubation period (time of exposure to


first symptoms) in animals is anywhere from 2 to 20 days.

Stages:
1st stage: Septicemic/ Leptospiremic Phase (4 – 7
days)
- onset of high remittent fever, chills, headache, anorexia,
nausea & vomiting, abdominal pain, joint pains, muscle
pains, myalgia, severe prostration, cough, respiratory
distress, bloody sputum.
2nd stage: Immune/ Toxic Phase (4 – 30 days)
- if severe, death may occur between the 9th & 16th day
2 types:
 Anicteric (without jaundice) – return of fever of a lower
degree with rash, conjunctival injection, headache,
meningeal manifestations like disorientation, convulsions
& signs of meningeal irritations (with CSF finding
of aseptic meningitis)
 Icteric (with jaundice) – Weil syndrome; hepatic & renal
manifestations: hemorrhage, hepatomegaly,
hyperbilirubinemia, oliguria, anuria with progressive renal
failure; shock, coma & congestive heart failure in severe
cases
3rd stage: Convalescence Phase
- Relapses may occur during 4th or 5th week

Pathognomonic Signs:
Leptospirosis — orange eyes
1. Usually asymptomatic
2. Low-grade afternoon fever
3.Night sweating
4.Loss of appetite
5. Weight loss
6. Easy fatigability – due
to increased oxygen
demand
7. Temporary amenorrhe
8. Productive dry cough
9. Hemoptysis

Signs and Symptoms:


Fever, Severe headache, Chills, Muscle aches, Vomiting, Flu-
like symptoms, Jaundice, Conjunctivitis, Red eyes, Abdominal
pain, Diarrhea, Rash

Drug of choice:

Aetiotropic drugs areantibiotics, such


as cefotaxime, doxycycline, penicillin, ampicillin,
and amoxicillin (doxycycline can also be used as
a prophylaxis).

Medical Management:
• First-choice drug is oral doxycycline, starting within 48
hours of illness (starting antibiotics can lead to
a Jarisch-Herxheimer reaction).
• Oral amoxicillin, ampicillin and doxycycline are effective
in mild-to-moderate infections.
• Intravenous penicillin G is the drug of choice for
severely ill patients.
• A recent clinical trial showed that third-generation
cephalosporins are as effective as doxycycline and
penicillin in the treatment of acute disease.4
• Chloramphenicol is also active against Leptospira but
should be reserved for critically ill patients.
• Supportive care and treatment of the hypotension,
haemorrhage, renal failure and liver failure.
• Vitamin K should be administered for
hypoprothrombinaemia.
• Immunity to leptospirosis is incomplete and so
patients should be advised to adopt lifestyle changes to
avoid re-exposure if possible.

Nursing Management:

• isolation of patient: urine must be properly disposed


• health teachings: keep a clean environment