Leptospirosis

Infectious Disease

RSI MUHAMMADIYAH PEKAJANGAN FAKULTAS KEDOKTERAN UNIVERSITAS MUHAMMADIYAH SEMARANG

The Causative Bacterium

Order Spirochaetales Treponema, Borrelia, Leptospira Family Leptospiraceae, susceptible to heat, cl, acid

Genus Leptospira, 26 serogroups, 250 serovars

interrogans, biflex, ictero hemorrhagica, hebdomidis Corkscrew shaped, delicate, flexible spirochete, Gram -ve

6 to 20

long & 0.1

thick, coiled, flagellate, actively motile

Leptospira under the Microscope

Dark Field Microscopy FL

Long, Thin, Highly Coiled

Epidemiology
Hujan ; lingkungan yang terkontaminasi Sanitasi kurang ; saluran pembuangan yang kurang memadai Daerah yang banyak tikus, kucing dan anjing yang telah terinfeksi Berjalan / bekerja tanpa alas kaki Sulit mencari titik sumber penyebab infeksi Setiap orang dapat terkontaminasi, bila lingkungan sudah terkontaminasi

Reservoirs of Infection
Tikus

(Rattus rattus, Rattus norvegicus, musculus)

Anjing Hewan liar Domesticated animals Caged game animals Lepstopira keluar melalui urine

Mus

Modes of Transmission
1. kontak langsung dengan jaringan atau air seni hewan yang terinfeksi Through skin abrasions, intact mucus membrane 2. kontak tidak langsung kulit yang luka terkena tanah, air, atau sayuran yang terkontaminasi mengkonsumsi makanan dan air yang terkontaminasi

3. Droplet infection
Inhalation of droplets of infected urine

Transmission

Urine Tissue Feces

Contam

Survive

Infection

Animal Source

Environment

Human

Pathogenesis of Severe Disease

merusak pembuluh Darah kecil Vasculitis

Leptospira

Perpindahan cairan dari intra ke ekstraseluler secara massal

Toksin merusak imun secara langsung

Kerusakan fungsi ginjal, pembuluh darah dan organ inti

Clinical Illnesses
Types

Anicteric (common 95% recover)

Icteric ( Weils Syndrome) (rare, fatal)

Hepato-renal syndrome
Hemorrhagic syndrome with ARF Atypical pneumonia syndrome Aseptic meningo-encephalitis Myocarditis, Chronic uveitis

Clinical Presentation
90% of Cases

Anicteric
Common, mild < 2% Mortality

Icteric
Rare, Severe 15% Mortality

10% of Cases

Anicteric Presentation
Leptospiremic Phase Immune Phase

Demam, Nyeri otot

Mild fever

Sakit kepala,mimisan
Mata berair

Meningism
Uveitis
I.P: 5 to 14 days (21days)

Nyeri perut

Prognosis and Mortality

Bleeding Cardiac Pulmonary

Renal

Fatality

Meningitis

Prevention
Prevention is difficult due to wild animal infection Good sanitation, Immunization of live stock

Personal hygiene, PPE, Water treatment

No useful human vaccines multiple serovars Doxycycline 200 mg weekly for at risk groups